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Home My WebLink AboutR C HEATH CONSTRUCTION - INSURANCE CERTIFICATEFlood & Peterson Ins 11/21/2006 9:30 PAGE 002/004 Fax Server ACORD- CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDOMYY) 11121106 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 80627 INSURERS AFFORDING COVERAGE NAIC • INSURED INSURERA St. Paul Travelers Insurance Company R.C. Heath Construction Co., Inc. INSURER B: National Union Fire Insurance P. 0. Drawer H INSURER C: Pinnacol Assurance Fort Collins, CO 80522 INSURER D: Fireman's Fund Insurance, Co. INSURER E: UU V CKAIBCS 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 BYTHE 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. TYPE OF INSURANCE POLICY NUMBER DATE EFFECTIVE PRATE E M IIp TION LIMITS A GENERAL LIABILITY DTCO298N6651- 09130/06 09/30/07 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE EX OCCUR TIA06 DAMAGE TO RENTED $300 OOO MED EXP (Ary we persm) $5 000 X PD Ded:10.000 PERSONAL &ADV INJURY $1 000 000 GENERAL AGGREGATE $2 000 O00 GEN'L AGGREGATE LIMITAPPLIES PER: POLICY amLOC PRODUCTS - COMP/OP AGG $2000000 A AUTOMOBILE LIABILITY ANY AUTO DT810298N6651TIL06 09/30106 09130/07 COMBINED SINGLE LIMIT (Es accident) $1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON•OWNED AUTOS X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO My - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ ANY AUTO $ B EXCESSIUMBRELLA LIABILITY X OCCUR CLANS MADE BE7227869 09130106 09130107 EACH OCCURRENCE $5 0-0-0 0OO AGGREGATE $5 000 000 f $ DEDUCTIBLE X RETENTION $ 10000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITYIT 4033691 10/01106 10101 /07 X WC STATU- I OTH. E.L. EACH ACCIDENT $500 000 ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERNEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS balm E.L. DISEASE - EA EMPLOYE $500000 E.L. DISEASE • POLICY LIMIT $500000 D OTHER Builders Risk MX198471771 09/30106 09/30107 $5114 All Other Projects $2.5111 Frame Projects $1,000 Ded I $250,000Transit/Offsite DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS RE: Deicing Facility, Bid no 5909 City of Fort Collins, Engineer, Engineer's Consultants respective officers and employees are named as additional Insured, but only as respects liability arising out of work performed by the named insured (Excluding (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fort Collins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 'An DAYS WRITTEN Adm in Services Purchasing Division NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL PO BOX 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Fort Collins, CO 80522-0580 REPRESENTATIVES. AUTHORIZED REPRESENT TIVE �JL+�fJLO�J .�wlt✓rara/GR r.�G. -- -- - ••--r - yr � UGH 0 ACORD CORPORATION 1988 Flood & Peterson Ins 11/21/2006 9:30 PAGE 003/004 Fax Server 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 alter the coverage afforded by the policies listed thereon. rrwrcL# d--* Izwvua) 2 013 Flood & Peterson Ins 11/21/2006 9:30 PAGE 004/004 Fax Server I DESCRIPTIONS (Continued from Page 1) 1 Workers' Compensation). Insurance policies do not provide professional liability for architects and engineers. Faxing to John Steven C City of FC 221-6707 & e-mailing to Ron Erickson @ RC Heath Construction.