HomeMy WebLinkAboutR C HEATH CONSTRUCTION - INSURANCE CERTIFICATE (3)r:ilanfi! 2,inf;
RCHFA
ACORD, CERTIFICATE OF LIABILITY
INSURANCE
0°912$07OmvY)
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
THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
ALTER
P O Box 270370
Fort Collins, CO 80527
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
R C Heath Construction Co , Inc
P O Drawer H
Fort Collins, CO 80522
INSURERA Travelers Insurance Company
INSURER B National Union Fire Insurance
INSURERC Pinnacol Assurance
INSURER D Fireman's Fund Insurance, Co
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
ICY
DATE IMM D IYYEOLICYJ
PDATE IMMIDDIYVON
LIMITS
A
GENERAL LIABILITY
DTCO29BN6651TIA
09/30/07
09/30/08
EACH OCCURRENCE
$1 000 000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE O OCCUR
PREM SEAMAGE TOE ENTEo nce
$300,000
MED EXP (Any one person)
$5 000
PERSONAL 8 ADV INJURY
$1 00O 000
X PD Ded 10,000
GENERALAGGREGATE
s2,000,000
GEN L AGGREGATE LIMIT APPLIES PER
PRODUCTS COMP/OP AGO
$2 OOO 000
POLICY X PRO LOC
JECT
A
AUTOMOBILE
LIABILITY
ANY AUTO
DT81029BN6651TIL07
09/30/07
09/30/08
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
ALL OW NED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Peraccident)
$
HIREDAUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY AGO
B
EXCESS/UMBRELLA LIABILITY
BE7274971
09/30/07
09/30/08
EACH OCCURRENCE
$5 00O 000
X OCCUR F-ICTAIMS MADE
AGGREGATE
$5 OOO 000
$
DEDUCTIBLE
$
X RETENTION $ 10000
C
WORKERS COMPENSATION AND
4033691
10/01/07 �10101/08
X we sTAru- OTH-
T V IMI
EMPLOYERS' LIABILITY
ANVCEFUMEETORIPARTNDED7 CUTIVE
E L EACH ACCIDENT
$500,000
EL DISEASE - EA EMPLOYEE
$500,000
OFFICERIMEMBER EXCLUDED'+
If yes tlescribe untler
SPECIAL PROVISIONS below
EL DISEASE -POLICY LIMIT
$500,000
D
OTHER Builders
MXI98471771
09/30/07
09/30108
5,000,000 not frame
Risk
2,500,000 frame
250,000Temp Loc/Transit
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
RE Deicing Facility, Bid no 5909
City of Fort Collins, Engineer, Engineer's Consultants respective officers
and employees are named as additional insured, but only as respects
liability arising out of work performed by the named insured (Excluding
(See Attached Descriptions)
City of Fort Collins
Admm Services Purchasing Division
PO Box 580
Fort Collins, CO 80522-0580
LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL gyp_ DAYS WRITTEN
E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL
iE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR
AUTHORIZED REPRESEN/T$pTIVE
Flaoo[ 'r r.t_joe eohl , Zr .Jr,
ACORD 25 (2001108) 1 of 3 #M394804 MAE 0 ACORD CORPORATION 1988
AUUKU Z�b (ZUVIlUt%) 2 of 3 #M394804
AMS 25 3 (2001/08) 3 of 3 #M394804