HomeMy WebLinkAboutR C HEATH CONSTRUCTION - INSURANCE CERTIFICATE (2)ACORD- CERTIFICATE OF LIABILITY INSURANCE 9/2(MMIDDIYYYY)
09/27/O6
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
P O Box 270370 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: St. Paul Travelers Insurance Company
R.C. Heath Construction Co., Inc. INSURER B: National Union Fire Insurance
P. Fort
Drawer H INSURER C: Pinnacol Assurance
Fort Collins, CO 80522 INSURERD:
INSURER E:
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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
ADD'
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIODIYY
POLICY EXPIRATION
DATE MM/DDrYY1
LIMITS
A
GENERAL LIABILITY
DTCO298N6651-
09/30/06
09/30/07
EACH OCCURRENCE
$1 000 000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE O OCCUR
TIA06
DAMAGE TO RENTED PREMISES (Ea occurrence)
$300 000
MED EXP (Any one person)
$5 000
X PD Ded:10,000
PERSONAL & ADV INJURY
$1 006 000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS -COMP/OP AGG
$2 00O 000
POLICY X PRO LOC
JECT
A
AUTOMOBILE
LIABILITY
ANY AUTO
DT810298N6651TIL06
09/30/06
09/30/07
COMBINED SINGLE LIMIT
(Ea 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 ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTOONLY: AGG
B
EXCESSIUMBRELLA LIABILITY
X OCCUR CLAIMS MADE
BE7227869
09/30/06
09/30/07
EACH OCCURRENCE
$5 000 000
AGGREGATE
$rj OQ fi Q66
DEDUCTIBLE
X RETENTION $ 10000
$
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
4033691
10/01/06
10/01/07
X WC STATU- OTH-
T I
E.L. EACH ACCIDENT
$500,000
ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
S yes, describeECIAL PROVISIONS below under
SP
E.L. DISEASE - EA EMPLOYEE
$500,000
E.L. DISEASE - POLICY LIMIT
$500,000
OTHER
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ 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)
City of Fort Collins
Admin Services Purchasing Division
PO Box 580
Fort Collins, CO 80522-0580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL A_ 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
ACORD 25 f2007/ORI 4 . s -i NR"Cn4n'
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