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HomeMy WebLinkAbout398430 CREATIVE HARDSCAPE - INSURANCE CERTIFICATEDater 4/5/2007 Timer 2r21 PH To: Creative R 1.970-221-6707 Pager 001 ACOR-P CERTIFICATE OF LIABILITY INSURANCE oa jMMfDO o PRODUCER (303)824-6600 FAX (303)370-0118 Moody Insurance Agency, Inc. 3773 CherryCreek North Drive Suite 800 Denver, CO 80209-3804 THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED Creative Hardscape Company, Inc. 2435 S. Cody Ct. Lakewood, CO 80227 INSURERA Continental Western Ins Co 10804 INSURER Pinnacol Assurance 41190 INSURER INSURER D INSURER EE. COVERAGES 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD rypE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY CNP2649092 10/01/2006 10/01/2007 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 250.000 CLAIMS MADE O OCCUR MED EXP (Any one person) $ 51000 A PERSONAL & ADV INJURY $ 1,000,0001 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE UMIT APPLIES PER. PRODUCTS - COMPlOP AGG $ 2,000,000 POLICY X JECT LOC AUTOMOBILE LIABILITY CNP2649092 10/01/2006 10/01/2007 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY A SCHEDULED AUTOS (Per person) $ X HIRED AUTOS BODILY INJURY $ X NON -OWNED AUTOS (Per accident) X Comp Ded $500 PROPERTY DAMAGE $ 1 Col I ison Ded $500 X (Pereaddent) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHERTHAN EA ACC $ AUTO ONLY. AGG $ EXCESSIUMBRELLA LIABILITY CU2646854 10/01/2006 10/01/2007 EACH OCCURRENCE $ 2,000,000 X OCCUR CLAIMS MACE AGGREGATE $ 2,000,000 A $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND 4073810 10/01/2006 10/01/2007 X I WCSTATI} I OTH- FP EMPLOYERS' LIABILITY E.L. EACH ACODENT $ 500,000 B ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? E L. DISEASE - EA EMPLOYE $ SQQ ,QQQ It yyes, dasenbe under EL. DISEASE -POLICY LIMIT $ 1,000, QQQ SPECI AL FROM SIGNS below OTHER Leased & Rented GNP2649092 10/01/2006 10/01/2007 Limit $125,000 A Equipment Ded $1,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS he City of Fort Collins is named as Additional Insured with regards to General Liability for work erformed as per form# CG2037 7/04. 10 day notice of cancellation for non-payment --The City of Fort Collins PO Box 580 Fort Collins, CO 80520 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILU RE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE AGUKUZD(ZUU1/U8) rH : ky/V)LZI—D/U/ ©ACORD CORPORATION 1988 Dates 4/5/2007 Times 2s21 PM Tot Creative B 1-970-221-6707 Paget 002 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or after the coverage afforded by the policies listed thereon. Ili .LJ tL.viluop Date, 4/5/2007 Time: 2,21 PM Toe Creative ® 1.970-221-6707 Page, 003 COMMERCIAL GENERAL LIABILITY CG 20 33 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II -. Who Is An Insured is amended to include as an additional insured any person or or- ganization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an addi- tional insured on your policy. Such person or or- ganization is an additional Insured only with re- spect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured. A person's or organizations status as an additional insured under this endorsement ends when your operations for that add€tkwml insured are com- pleted, B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to: 1. "Bodly injury", "Property damage" or "personal and advertising injury" arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying ser- vices, including: a, The preparing, approving, or falling to pre- pare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifica- tions; or b. Supervisory, inspection, architsctural or engineering activities. 2. "Bodily injury" or "property damage" occurring after: a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than ser- vice, maintenance or repairs) to be per- formed by or on behalf of the additional in- sureds) at the location of the covered operations has been completed; or b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontrac- tor engaged in performing operations for a principal as a part of the same project. CG 20 33 07 04 0 ISO Properties, Inc-, 2004 Page 1 of 1 EI