HomeMy WebLinkAboutG L HOFF COMPANY - INSURANCE CERTIFICATEACORD.e CERTIFICATE OF LIABILITY INSURANCE 12118/ s°"YY'
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4821 Wheaton Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P O Box 270370
Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: St. Paul Travelers Insurance Company
G.L. Hoff Company INSURER B: Pinnacol Assurance
1815 W 12th Street; P.O. Box 7448 INSURER C:
Loveland, CO 80537
INSURER D:
INSURER E:
CflVFRA(OFS
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IN3R
LTR
MID'
IINSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE(MMMDIYYI
POLICY EXPIRATION
DATE MMIDD
LIMITS
A
GENERAL LIABILITY
DTC0325D6515TIL07
01/01107
03/01/07
EACH OCCURRENCE
$1 000 OOO
COMMERCIAL GENERAL LIABILITY
PREMISES (E, occurrence) DAMAGE TO RENTED
$300000
CLAIMS MADE O OCCUR
MED EXP (Any one person)
$5 000
PERSONAL B ADV INJURY
$1 00D 000
X PD Ded:2,500
GENERAL AGGREGATE
$2 000 000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$2000000
POLICY PRO LOC
JECT
A
AUTOMOBILE
LIABILITY
ANY AUTO
DT810325D6515TIL07 '
' afOT107
03/01 7
r t`
eaccSINGLE LIMIT
Eaccident)
( )
$1,000,000
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
) Q
! OOf
X
BODILY INJURY
(Per accident)
$
X
i2
RISK
is
NIAN.AG
U1 LINS
_ AENT
PROPERTY DAMAGE
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
0
$
AUTO ONLY: AGG
A
EXCESSIUMBRELLA LIABILITY
X OCCUR F1 CLAIMS MADE
DTSMCUP325D6515TIL
01/01/07
03/01107
EACH OCCURRENCE
$1000000
AGGREGATE
$1 006 000
$
_
_
$
DEDUCTIBLE
$
X RETENTION $ 10000
B
WORKERS COMPENSATION AND
2242590
01/01/07
01/01/08
TH-
X WORY C LIMIT ER
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$5OO OOO
E.L. DISEASE - EA EMPLOYEE
s500,000
OFFICER/MEMBER EXCLUDED?
?(yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE -POLICY LIMIT
s500,000
A
OTHER
OT6606062BO90TIL07
01/01/07
03/01/07
Limit $1,000,000
Builders Risk
Deductible $1,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS
Certificate holder is named as additional insured as their interest
may appear in regards to the Operations of the named insured. (Excluding
Workers' Compensation) Bond Renewal
City of Fort Collins
Bond Renewal
P.O. Box 580
Fort Collins, CO 80522
LID ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN
:E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
iE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
ACURU z5 (z001101 1 Of 2 #M366994 TJR 0 ACORD CORPORATION 1988
ACORD. CERTIFICATE OF LIABILITY INSURANCE 1DATE 2118/06Onrrv)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4821 Wheaton Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P O Box 270370
Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: St. Paul Travelers Insurance Company
G.L. Hoff Company INSURER B: Pinnacol Assurance
1815 W 12th Street; P.O. BOX 7448 INSURER C:
Loveland, CO 80537
INSURER D:
INSURER E:
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 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE M DD
POLICY EXPIRATION
DATE M DD
LIMITS
A
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE � OCCUR
X PDDed:2,500
0
DTC0325D6515TIL07
01/01/07
03/01/07
EACH OCCURRENCE
$1000000
DAMAGE TO RENTEDoccurrancel
$300 000
MED EXP (Any one person)
s5 000
PERSONAL BADVINJURY
$1000000
GENERAL AGGREGATE
$2 000 000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY F PROJECT 7 LOC
PRODUCTS - COMP/OP AGG
$2000000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON -OWNED AUTOS
DT810325D6515TIL07
CIT
01/01/07
` r
5
of 1-lix i
03/01/07
QQ
OOU
vLL)NS
COMBINED SINGLE LIMIT
(Ea accident)
$1000 000
, r
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
(Per OPE TY DAMAGE
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
A
EXCESSIUMBRELLA LIABILITY
X1 OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $ 10000
OTSMCUP325D6515TIL
01/01/07
03/01/07
EACH OCCURRENCE
$1 000 000
AGGREGATE
$1 000 000
$
$
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
Has, describe under
SPECIAL PROVISIONS below
2242590
01/01/07
01/01/08
TH-
X I OR WC SYTATT� OER
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE - EA EMPLOYEE
$500,000
E.L. DISEASE - POLICY LIMIT
$500 000
A
OTHER
Builders Risk
OT6606062BO90TIL07
01/01/07
03/01/07
Limit $1,000,000
Deductible $1,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
RE: Pedestrian Bridges
Certificate holder is named as additional insured, but only as respects
liability arising out of work performed by the named insured (Excluding
Workers' Compensation).
City of Fort Collins
PO BOX 580
Fort Collins, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPREE TIVE
w
_
ACORD 25 (200110B) 1 of 2 #M366994 TJR 0 ACORD CORPORATION 1988
rlinn*8• 9A7An
GLI40F
ACORD. CERTIFICATE OF LIABILITY
INSURANCE
DATE j
12/18106Dmrv)
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc
4821 Wheaton Drive
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P O Box 270370
Fort Collins, CO 80527
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER A: St. Paul Travelers Insurance Company
G.L. Hoff Company
1815 W 12th Street; P.O. BOX 7448
Loveland, CO 80537
INSURER B. Pinnacol Assurance
INSURER C.
INSURER D:
INSURER E:
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 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY IMM DUIYI E
DAITE MIWEXPIRATION
LIMITS
A
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE F OCCUR
X PCDed:2,500
DTC0325D6515TIL07
01/01107
03/01/07
EACH OCCURRENCE
$1 000 000
DAMAGE TO RENTED
$300000
MED EXP (Any one person)
$5 000
PERSONAL &ADV INJURY
$1 000 000
GENERAL AGGREGATE
s2.000.000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY F PRO LOC
JECT
PRODUCTS - COMP/OP AGG
$2000000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
DT810325D6515TIL07
01/01/07
03/01/07
COMBINED SINGLE LIMIT
(Ea accident)
$1 ,000 ,000
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
A
EXCESS/UMBRELLALIABILITY
X I OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $ 10000
DTSMCUP325D6515TIL
01/01/07
03/01/07
EACH OCCURRENCE
$1000000
AGGREGATE
$1 000 000
$
$
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
2242590
01/01/07
01/01/08
X I DRY WCSTATU- I OTH-
fIL
E.L. ACCIDENT
OEACH
$SOO 00
E.L. DISEASE - EA EMPLOYEE
s500,000
E.L. DISEASE - POLICY LIMIT
s500,000
A
OTHER
Builders Risk
OT6606062BO90TIL07
01/01/07
03/01/07
Limit $1,000,000
Deductible $1,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
RE: Bid #5878 Pedestrian Bridge and Abutments
City of Fort Collins
Attn: John Stephen
215 N. Mason St., Second Floor
PO Box 580
Fort Collins, CO 80522-0580
ACORD 25 (2001/08) 1 of 2 #M366994
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10_ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
AUTHORIZED
Tip
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