HomeMy WebLinkAboutPrecision Directional Drilling - Insurance Certificate AC Zs CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
`..•/ 1 12/27/2024
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 NANTACT
ME: Shana Tamayo
CRS Insurance Brokerage PHONE 303 996 7800 FAX No:303 757-7719
9780 S Meridian Blvd Suite 400
ML
Englewood CO 80112 ADDRESS: stamayo@crsdenver.com
INSURERS AFFORDING COVERAGE NAIC 0
INSURER A: Pinnacol Assurance 41190
INSURED INSURER B: Sentry Insurance a Mutual Company 24988
Precision Directional Drilling
2425 Ridge Dr. lrlsuRERc:
Grand Junction CO 81504 INSURERD:
INSURER E:
i
INSURER F:
COVERAGES CERTIFICATE NUMBER:63706947 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.
Abe --- ---------- LI POCY EFF POLICY EXP --------- ----
LTR TYPE OF INSURANCE INSDyy�ypl POLICYNUMBER I IMMIDDIYYYY) MM/DDIYYYY LIMITS
B X COMMERCIAL GENERAL LIABILITY Y A0254051005 7/1/2024 7/1/2025
�_ EACH OCCURRENCE $1.000,000
CLAIMS-MADE i X i OCCUR PREMISESDAMAGE LaocRENTEDwrren-e_ $500,000
MED EXP(Any one person) $5,000
PERSONAL&ADV INJURY $1.000,000
GEN'LAGGREG��ATE LIMIT APPLIES PER: I I GENERAL AGGREGATE $3,000,000
POLICY'u PRO-- 71 LOC
JECT
PRODUCTS-COMP/OP AGG $2,000,000
OTHER: $
B AUTOMOBILE LIABILITY A0254051 001 7/1/2024 i 7/1/2025 COMBINED SINGLE LIMIT $1,000,000
X ANY AUTO I BODILY INJURY(Per person) $
_i OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
HIRED NON-OWNED
X X PROPERTY Kdde DAMAGE
AUTOS ONLY AUTOS ONLY a____de-mJ___-_-_-___._-- -$—....----------._----
i g
e X ! UMBRELLA LIAR X OCCUR i A0254051 006 7/1/2024 7I1/2025 EACH OCCURRENCE $5.000,000
EXCESS LIAR CLAIMS•MADE
AGGREGATE $5,000,000
DED X RETENTION$
A WORKERS COMPENSATION 4204090 1/1/2025 111/2026
AND EMPLOYERS'LIABILITY YIN !X STATUTE ERH
ANYPROPRIETOFUPARTNERIEXECUTIVE OFFICER/MEMBEREXCLUDED? iNIA E.L.EACH ACCIDENT $1,000,000
(Mandatory In NH)
r
E L.DISEASE-EA EMPLOYEE $1,000,000
II yes,describe under i
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
B I Inland Marine A0254051 003 j 7/1/2024 711/2025 Scheduled Equip 330,094
ACV/Special Form DeasedlRented Equip 200,000
1,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached It more apace Is required)
City of Fort Collins is included as additional insured for ongoing and completed operations on the General Liability and included as additional insured on the
Auto Liability with respect to 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 Engineering Department ACCORDANCE WITH THE POLICY PROVISIONS.
281 North College Avenue P.O. Box 580 AUTHORIZED REPRESENTATIV
Fort Collins CO 80522-0580 r '
I
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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