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HomeMy WebLinkAboutLighthouse Transportation Group, LLC - INSURANCE CERTIFICATE i DATE(MMIDD/YYYY) AFRO® CERTIFICATE OF LIABILITY INSURANCEF4/25/2024 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 NAME: IMA Construction Team _ IMA, Inc. -Colorado PHONE FAX 1705 17th Street, Suite 100 ac No): Denver CO 80202 ADDRESS: constructoncerts@imacorp.com _ INSURER(5)AFFORDING COVERAGE NAIC U INSURER A: Berkley Assurance Company 39462 INSURED LIGHTRA•01 INSURERB:Westfield Specialty Insurance Company 16992 Lighthouse Transportation Group, LLC - 11861 Bradburn Boulevard INSURERc:Zurich American Insurance Company 16535 Westminster, CO 80031 INSURERo___ INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:587262189 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. ILTR TYPEOFINSURANCE AND WVD-BRI - POLICY NUMBER MMO/LIDDNYYY MNDNYYP I - LIMITS c X ICOMMERCIAL GENERAL LIABILITY Y GLO 4426201-00 4/29/2024 4/29/2025 EACH OCCURRENCE $1,000,000 E TO RENTffl� CLAIMS-MADE I OCCUR PREMISES Ea occurrence $300,000_ MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER; _GENERAL AGGREGATE $2,000,000 POLICY a PRO- LOC --- _ — JECTPRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ C AUTOMOBILE LIABILITY Y BAP 4306100-00 4/29/2024 4/29/2025 COMBINED LIMIT $1,000,000 X ANY AUTO I BODILY INJURY(Per person) $ OWNED SCHEDULED I BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED Y DAMAGE $ AUTOS ONLY AUTOS ONLY PROPERTY_(Per PERT $ B UMBRELLA LIAR X OCCUR SXS 4426203-00 4/29/2024 4129/2025 EACH OCCURRENCE s 5.000.000 X ExCESSLIAB CLAIMS-MADE AGGREGATE $5,000,000 DED RETENTION$ $ WORKERS COMPENSATION PTATUTE ERH AND EMPLOYERS'LIABILITY y/N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICERWEMBEREXCLUDED? N/A ____ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ It yes,describe under IDESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Professional Liability PCXB-5024703-0424 4/29/2024 4/29/20257Esch $1,000,000 $1,000,000 $10,000 DESCRIPTION OF OPERATIONS r LOCATIONS r VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached II more space Is required) Pollution Liability Coverage: Policy#PCXB-5024703-0424 Effective Dates 4/29/2024-4/29/2025 Insurer D:See Above $1,000,000 Aggregate;$1,000,000 Occurrence,$10,000 Deductible Leased&Rented Equipment Coverage: Policy#IH4-J088421-03 Effective Dates:4/29/2024-4/2912025 Insurer:The Hanover Insurance Company $250,000 Limit;$1,000 Deductible; Replacement Cost See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins CO 80522 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 824: 2 ' of 14 AGENCY CUSTOMER ID: LIGHTRA-01 LOC#: ACCO® ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED IMA, Inc.-Colorado Lighthouse Transportation Group, LLC POLICY NUMBER 11861 Bradburn Boulevard Westminster,CO 80031 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Installation Floater Coverage: Policy#IH4-J088421-03 Effective Dates:4/29/2024-4/29/2025 Insurer:The Hanover Insurance Company $1,000,000 Limit,$5,000 Deductible,$1,000,000 Temporary Storage/$250,000 Transit Limit Contractors Equipment Coverage: Policy#IH4-J088421-03 Effective Dates:4/29/2024-4/29/2025 Insurer:The Hanover Insurance Company $334,878 Scheduled Contractors Equipment;$1,000 Deductible Per Occurrence City of Fort Collins is included as Additional Insured on the General Liability and Automobile Liability Policies,if required by written contract or agreement, subject to the policy terms and conditions. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 824: 3 - of 14