HomeMy WebLinkAboutCastle Rock Construction Company of Colorado, LLC - Insurance Certificate DATE(MM/OO/YYYY)
ACf7R" CERTIFICATE OF LIABILITY INSURANCE
`.. 12131/2024
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
CRS Insurance Brokerage PHONE NAME: Katie SmOtherS — FAX �-
9780 S Meridian Blvd Suite 400 • 303-996-7800 A/c No:303-757-7719
Englewood CO 80112 nDoRess: ksmothers@crsdenver.com
INSURERS AFFORDING COVERAGE NAIC N
--------- INSURERA:Travelers Pro Casual of AM 25674
____ _ _ _ ..___.- -_ ---- .._--- -
INSURED CASTROG-01 INSURERB:Charter Oak Fire Insurance Co. 25615
Castle Rock Construction Company of Colorado LLC
6374 S. Racine Circle INSURERC.Pinnacol Assurance 1 41190
Centennial CO 80111 INSURERD:Travelers Indemnit Co of CT
INSURER E: -- ----y - -- 25682 82
INSURER F:
COVERAGES CERTIFICATE NUMBER:683075874 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
.I___ WV- POLICY NUMBER MMIDD/YYYY MM/DDIYYYY
INSR AOOL SUBR�__. POLICY EFF r
LTR TYPE OF INSURANCE � LIMITS
B X COMMERCIAL GENERAL LIABILITY Y C0325D9449 12/31/2024 12/31/2025 EACHOCCURRENCE $1,000.000
_ CLAIMS-MADE I X OCCUR ! MA E O NT —
PI REMISES�aoca,rrence $300,000
MED EXP(Any one person) $5,000
PERSONAL&ADV INJURY $1.000,000
i
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
X j POLICY r u jECT X� LOG1 PRODUCTS-COMP/OP AGG $2,000,000
i
OTHER: $
D AUTOMOBILE LIABILITY 81011-610369 12/31/2024 12/31/2025 COMBINED SINGLE LIMIT $1,000,000
BAcci_denl)
X ANY AUTO
BODILY INJURY(Per person) $
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
HIRED I NON-OWNED $
PROPERTYDAMAGE
AUTOS ONLY I X AUTOS ONLY i__CPer accident)_ - -
A X ' UMBRELLA LIAB X OCCUR CUP9M548098 12/31/2024 12/3112025 : EACH OCCURRENCE $10,000.000
EXCESS LIAB CLAIMS--M-
ADE AGGREGATE $10,000,000
—
DED
RETENTION$In nnn $
C WORKERS COMPENSATION 4220945 1/1/2025 1/1/2026 IX , STATUTE I ERH _AND EMPLOYERS'LIABILITY
Y I N
ANYPROPRIETORjPARTNER.!EXECUTIVE
OFFICER/MEMBEREXCLUDED? � N/A j E.L.EACH ACCIDENT $1,000,000 _
(Mandatory In NH)II yes,describe under l I E.L.DISEASE-EA EMPLOYEE $1,000,000
� i
DESCRIPTION OF OPERATIONS bebw IE.L.DISEASE.POLICY LIMIT $1,000,000
A Leased/Rented Equipment 630513456655 12/31/2024 1 12/31/2025 Limit 1,500,000
Speaal/ACV
Deductible 25,000
i
i
i
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
Certificate holder is included as additional insured on the General Liability with respect to ongoing operations of the named insured for the certificate holder as
required by written contract.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS.
281 N. College Ave. AUTHORIZED REPRESENTATIVE
Fort Collins CO 80526
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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