HomeMy WebLinkAboutARMADILLO FENCING - INSURANCE CERTIFICATE (6)ACORD- CERTIFICATE OF LIABILITY INSURANCE DATE
(MMI DNYYY)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
HRH of Colorado ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
720 S. Colorado Blvd Ste 600-N HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 469025
Denver, CO 80246-9025 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: Travelers Indemnity of America 25666
Armadillo Fencing Corp. INSURER B. Travelers Property Casualty Co. of A 36161
5795 Ideal Drive INSURER C: Pinnacol Assurance 10780
Erie, CO 80516-9417 INSURER D:
INSURER E:
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
N
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDD
POLICY EXPIRATIONSR
DATE MMIDDIYY
LIMITS
A
GENERAL LIABILITY
0748C220TIA06
10/01/06
10/01/07
EACH OCCURRENCE
$1 QQQ QQQ
kX COMMERCIAL GENERAL LIABILITY
CLAIMS MADE O OCCUR
DAMAGE TO RPREMIS (E.ENTED
$1 OQ 000
MED EXP (Any one person)
$5 QQQ
AI# CG D2 46
PERSONAL 8 ADV INJURY
$1 000 000
(08/05)
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$2 QQQ 000
POLICY X PRO-
F T X LOC
B
AUTOMOBILE
LIABILITY
ANY AUTO
0748C220TIL06
10/01/06
10/01/07
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON-OWNEDAUTOS
X
BODILY INJURY
(Per accident)
$
X
Ltd Pollution
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
B
EXCESSIUMBRELLA LIABILITY
X OCCUR CLAIMS MADE
0748C220TIA05
10/01/06
10/01/07
EACH OCCURRENCE
$2 QQQ 000
AGGREGATE
$2 000 QQQ
RDEDUCTIBLE
X RETENTION $ 10 000
$
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
4058096
10101f06
10101/07
X WC STATU- I OTH-
FIR
E.L. EACH ACCIDENT
$500000
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If as, describe under
y
SPECIAL PROVISIONS below
E.L. DISEASE - EA EMPLOYE
$500,000
E.L. DISEASE - POLICY LIMIT
$500,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENTI SPECIAL PROVISIONS
RE: Written Contracts with the Certificate Holder.
The following are Additional Insureds as respects General Liability only
if required by written contract and coverage applies only as respects
(See Attached Descriptions)
City of Ft. Collins
PO Box 580
Fort Collins, CO 80522
w1v
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL AW 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
An^MM
REPRESENTATIVE
0-
___.,--/ I yr 4 *m0u;)yfa MAS 0 ACORD CORPORATION 1988
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.
• •-"^" '-"" -"" ^"�� c or s FFM.SUO`J/6
DESCRIPTIONS (Continued from Page 1)
work performed by the Insured for the Additional Insureds.
All coverage terms, conditions and exclusions of the policy apply.
Additional Insureds: City of Ft. Collins.
The Additional Insured endorsement which is referenced above under "Type
of Insurance -General Liability" is attached.
* The following cancellation conditions always apply:
- 10 days for non-payment of premium
- If policy shown, 10 days for Workers' Compensation for fraud;
material misrepresentation; non-payment of premium; other reasons
approved by the Commissioner of Insurance
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY
BLANKET ADDITIONAL INSURED
(CONTRACTORS)
This endorsement modifies.insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
1, WHO 15 AN INSURED — (Section II) is amended
a) The Insurance provided to the additional In-
to include any person or organization that you
sured does not apply to "bodily injury" or
agree In a "written contract requiring insurance"
"property damage" caused by "your work'
to Include as an additional Insured on this Cover-
and included In the "products -completed op -
age Part, but:
erations hazard" unless the "written contract
a) Only with respect to liability for "bodily injury",
requiring insurance" specifically requires you
"property damage" or "personal injury"; and
to provide such coverage for that additional
b) If, and only to the extent That, the injury or
Insured, and then they Insurance provided tothe additional Insured applies only to such
damage Is caused by acts or omissions of
you or your subcontractor in the performance
"bodily Injury" or "property damage" that oa
of "your work" to which the "written contract
curs before the end of the period of time for
which the "written contract requiring insur-
requiring insurance" applies, The person or
organization does not qualify as an additional
ance" requires you to provide such coverage
insured with respect to the independent acts
or the end of the policy period, whichever is
earlier.
or omissions of such person or organization.
2. The insurance provided to the additional Insured
g The insurance provided to the additional insured
by this endorsement is excess over any valid and
by this endorsement is limited as follows:
collectible "other Insurance', whether primary,
a) In the event that the Limits of insurance of
excess, contingent or on any other basis, that is
this Coverage Part shown In the Declarations
available to the additional insured for a loss we
exceed .the limits of liability required by the
cover under this endorsement. However; if the
"written contras requiring insurance", the in-
"written contract requiring insurance" specifically
surance provided to the additional insured
requires that this insurance apply on a primary
shall be limited to the limits of liability re-
basis or a primary and non-contributory basis,
quired by that "written contract requiring in-
this Insurance is primary to "other insurance"
surance", This endorsement shall not in.
available to the additional Insured which covers
crease the limits of insurance described In
that person or organization as a named insured
Section III — Limits Of Insurance.
for such loss, and we will not share with that
b) The insurance provided to the additional in-
"other insurance". But the insurance provided to
sured does not apply to "bodily injury", "prop•
the additional Insured by this endorsement still Is
erty damage" or "personal injury" arising out
excess over any valid and collectible 'other In -
of the rendering of, or failure to render, any
surance", whether primary, excesa, contingent or
professional architectural, engineering or sur-
on any other basis, that Is available to the addi-
veying services, including:
tional insured when that person or organization is
1. The preparing, approving, or failing to
an additional insured under such "other insur-
ance".
prepare or approve, maps, shop draw.
ings, opinions, reports, surveys, field or-
4. As a condition of coverage provided to the
ders or change orders, or the preparing,
additional insured by this endorsement:
approving, or failing to prepare or ap-
a) The additional Insured must give us written
prove, drawings and specifications; and
notice as soon as practicable of an "occur-
11, Supervisory, inspection, architectural or
rence" or an offense which may result in a
engineering activltles,
claim. To the extent possible, such notice
should include;
CC,0 2005 The SI,�aui,TTavelers Companies, ins