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Home My WebLink AboutDELTA CONSTRUCTION - INSURANCE CERTIFICATEACORDM CERTIFICATE OF LIABILITY INSURANCE ATE MMIDDYYYY 03/30/20071 PRODUCER (970)484-0097 FAX (970)484-7077 Herbert -Ewing -Leavitt 2537 Research Blvd Suite 202 Fort Collins, CO 80527-2289 THIS CERTIFICATE IS ISSUED AS A 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 Delta Construction of Northern Colorado, Inc. 208 Raquette Or Fort Collins, CO 80524 INSURERA CNA INSURERB Pinnacol Assurance INSURERc Firemen's Fund 41190 INSURER D. INSURER E. rnVFRAr:FR 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 ADDT TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE IMMIDDNYI POLICY EXPIRATION DATE IMMIDD[YYI LIMITS GENERAL LIABILITY 2092663776 03/01/2007 03/01/2008 EACH OCCURRENCE_ $ 1,000,000 X COMMERCIAL GENERAL. LIABILITY __ DAMAGE TO RENTED PREMISES IF, dr,rrrrcinr,r,n _ $_ 100,000 CLAIMS MADE OCCUR MED EXP (Any one person) $ 5,000 A X Prof Liab CNA POLICY #CNP2882508 09/08/2006 09/08/2007 PERSONAL BADVINJURY $ 1,000,000 X Waiver of Subro — $ 2,000,000 GENERALAGGREGATE GENL AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO- LOC ECT __.__—_____ _ _-_____.—_ AUTOMOBILE LIABILITY 2092663809 03/01/2007 03/01/2008 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) 1,000,000 ALL OWNED AUTOS BODILY INJURY $ — A SCHEDULED AUTOS (Per per son) —_ HIRED AU70S BODILY INJURY i $ NONOWNEDAUTOS (Per accident) PROPER(Y DAMAGE $ (Per accdent) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO Of HLR TITAN LA ACC $ - AUTOONLY AGG $ EXCESS/UMBRELLA LIABILITY 2092663776 03/01/2007 03/01/2008 EACH OCCURRENCE $ 10,000,000 X J OCCUR L-] CLAIMS MADE AGGREGATE $ 10,000,000 DEDUCT IBI F X RETENTION $ 10,00 $ —_ WORKERS COMPENSATION AND 3298114 07/01/2007 07/01/2008 1 WCSTATU- OIH- - -'-- - R_ --------- EMPLOYERS' LIABILITY c.L_EACH ACC IDENT $ B ANY PROPHitTOR/PAkTNERAXFCUHVI.. — E L DISEASE - EA EMPLOYEE __---500,000 $ 500,000 OFFICER/MEMBER EXCLUDED',' If yes, describe under --------------------- -- SPECIAL PROVISIONS celow E.L. DISEASE - POLICY LIMIT $ 500,000 OTHER INLAND MARINE/BUILDERS MXI98473782 04/30/2007 04/30/2008 $10,000,000 other than frame C RISK INCL V&MM, THEFT, REPL COST 2,500,000 Frame j Rented/Leased Egmt $100,000 _ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ertificate holder is named as additional insured, but only as respects liability arising out of work erformed by the named insured (Excluding Worker's Compensation). General Liability is Primary and Non-contributory. 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 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Dianne Littlefield/DEL ACORD 25 (2001/08) ©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. ACORD 25 (2001/08) ACORq CERTIFICATE OF LIABILITY INSURANCE 1 DATE 03/30/2007) /D007 PRODUCER (970)484-0097 FAX (970)484-7077 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Herbert -Ewing -Leavitt ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2537 Research Blvd HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 202 Fort Collins, CO 80527-2289 INSURERS AFFORDING COVERAGE NAIC # INSURED Delta Construction of Northern Colorado, Inc. INSURERA CNA 208 Raquette Dr NSURERB Pinnacol Assurance 41100 Fort Collins, CO 80524 ; INSURE l:cFiremen's Fund -- — .. INSURE R D INSURER L 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 DLTR INSD' rypE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY 2092663776 03/01/2007 03/01/2008 EACH OCCURRENCE $ 1,000,000 Xi COMMERCIAL GENE RAI LIABILITY DAMAGE TO RENTED yREM18ESXa,u"un:nuaT_ $ __ 1DD,000 J CLAIMS MADE X I OCCUR MED EXP (Any one person) $ , 5 000 A X Prof Liab NA POLICY #CNP2882508 09/08/2006 09/08/2007 PERSONALaADVINURY $ 1,000,000 X Waiver of Subro GENERAL AGGRFGATE $ 2,000,000 GEN'L AGGREGATE. LIMIT APPI IES PER PRODUC E8 - COMP/OP AGG $ 2,000,000 POLICY X' PRO- JECT LOC — ----- AUTOMOBILE LIABILITY 2092663809 03/01/2007 03/01/2008 COMBINED SINGLE LIMIT $ X - ANY AUTO (Ea accident) 1,000,000 ALL OWNED AUTOS BODILY INJURY $ - A SCHEDULED AUTOS (Per person) ------ ---- ---- HIRED AU TOS BODILY INJURY $ -- NON -OWNED AUTOS ( Per accident) PROPERTY DAMAGE $ - ----------------- (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AU TO - HER THAN EA ACC $ AU AUTO ONLY AGG - - $ EXCESS/UMBRELLA LIABILITY 2092663776 03/01/2007 03/01/2008 EACH OCCURRENCE $ 10,000,000 X I OCCUR IA AGGREGATE_ $ 10,000,000 CLAIMS MADE A $ DEDUCTIBLE X RETENTION $ 10,00 $ WORKERS COMPENSATION AND 3298114 07/01/2007 07/0172 008 WC STATU- OTH- EMPLOYERS' LIABILITY - TOBY LIMIT B ANYCER/ ETORJPARTNER/EXECUTIVE EL EACHACCIDENT $ SOO, OOO FFICER/MEMUER EXCLUDED-7 EL DISEASE - EA EMPLOYFE $ 500 000 It yes, describe under SPHERAL PROVISIONS below L I DISEASE. - POLICY LIMIT , $ 500,000 OTHER INLAND MARINE/BUILDERS MXI98473782 041 112007 04/30/2008 $10,000,000 other than frame C ISK INCL V&MM, THEFT, REPL COST 2,500,000 Frame Rented/Leased Eqmt $100,000 DESCRIPTION OF OPERATIONS (LOCATIONS (VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT i SPECIAL PROVISIONS 11 Operations/All Loctions 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 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Dianne Littlefield/DEL Ma Umu 40 Ituu Itub) ©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. AI.UKU Zb (ZUUIIUU)