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Home My WebLink About380591 J 2 CONSTRACTING - INSURANCE CERTIFICATEACORD CERTIIFICATE OF LIABILITY INSURANCE 10/ 200 ' PRODUCER (303) 824-6600 FAX: (303) 370-0118 Mood Insurance Agency, Inc. Y 4 YI 3773 Cherry Creek North Drive Suite 800 Denver CO 80209-3804 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 J-2 Contracting Company PO BOX 129 Greeley CO B0632 INSURERA'. Bituminous Casualty Corp 02075 INSURER B. Pinnacol Assurance 41190 INSURER C: 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 (,EMITS SHOWN MAYHAVE.@EEN.REDJCED BY PAID CIA MS ILTR NSR ADD-L POLICY IN%RD TYPE OF INSURANCE POLICY NUMBER D TEYMMIDOIYYE PDATE MMMDIYY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 PREMISES Ed occurence $ 100,000 A X COMMERCIAL GENERALLIABILRY _ CLAIMS MADE 1XI OCCUR CLP3237001 1/1/2007 1/l/2008 MED EXP Any oneperson) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 Blanket Additional GENERAL AGGREGATE $ 2,000,000 Insured Endorsement _ GEN'L AGGREGATELIMIT APPLIES PER. PRODUCTS - COMPIOP AGG $ 2,000,000 #GL-4362 (12/04) Attached POLICY X PE� LOC AUTOMOBILE X LIABILITY ANYAUTO COMBINED SINGLE LIMIT F. aecibenl) $ 1, DDD, ODD BODILY INJURY (Per person) $ A ALL OWNED AUTOS SCHEDULED AUTOS CAP3509264 1/l/2007 1/1/2008 BODILY INJURY (Per accident) $ X X HIRED AUTOS NON,OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA A $ ANY AUTO $ AUTO ONLY: AGG EXCESSNMBRELLA LIABILITY EACH OCCURRENCE $ 1,000,000 X OCCUR 0CLAIMSMADE AGGREGATE $ 1,000,000 $ A DEDUCTIBLE CUP2579804 1/1/2007 1/l/2008 X RETENTION $10,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNEMEXECITIVE X WC STAMU- OTH- ITS EL EACH ACCIDENT $ 1,000,000 E. L. DISEASE - EA EMPLOYE $ 1,000,000 OFFICERIMEMBER EXCLUDED? Ryes, describe under SPECIAL PROVISIONS be. 3114522 10/1/2007 10/1/2008 ELDISEASE- POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS&OCATIONSNEHICL VEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Re: LPATH Berm Erosion Protection Measures, Fort Collins, CO The City of Fort Collins and Anderson Consulting are named as Addtional Insureds as repects the General Liability only if required by written Contract and coverage applies only as respects work performed by the Insured for the Additions Insureds. This certificate is subject to the terms, conditions, and exclusions of the policies. In the event of cancellation for non-payment of premium, a 30-day notice of cancellation will apply. City of Fort Collins 215 North Mason Street 2nd Floor 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 DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE AUTHORIZED REPRESENTATIVE R Bruscino/ROSBRU ACORD 25 (2001108) 0 ACORD CORPORATION 1988 IMcn79—no, moo., n>,.e 1 11 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) INS025 I0108t08a Page 2 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTORS ADDITIONAL INSURED ENDORSEMENT - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SECTION 11- WHO IS AN INSURED is amended to Include: Any 'owner", "contractor, 'construction manager', "engineer" or 'architect' if it is required in your written contract or written agreement executed by you and all other parties to the contract or agreement prior to any loss that such person(s) or organization(s) be added as an additional Insured on your policy for completed operations but only for the project designated in your written contract or written agreement and only with respect to "bodily injury" or "property damage" included in the 'products -completed operations hazard" and caused, at least in part, by your negligence and with respect to liability resulting from: A. 'Your work' performed for the additional insured(s), or B. Acts or ornissions of the additional insured(s) in connection with their general supervision of 'your work'. With respect to the insurance afforded such additional insureds in connection with this endorsement and the above referenced Commercial General Liability Form,, the following additional provisions apply to limit that coverage: 1. We will have no duty to defend the additional insured against any 'suit' seeking damages for "bodily injury" or'property damage" until we receive written notice from the additional insured requesting that we defend it in the 'suit." 2. The Limits of Insurance applicable to the additional insureds under this endorsement are the minimum limits specified in the written contract or agreement requiring this coverage, or as stated in SECTION III - LIMITS OF, INSURANCE of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM, whichever is less. These Limits of Insurance are inclusive of and not in addition to the Limits of Insurance described in SECTION III of that form. 3. As additional conditions of coverage under this form, an additional insured under this endorsement will as soon as practicable: a. Give written notice to us of an 'occurrence" which may result in a claim. This shall include: (1) How, when and where the "occurrence" took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence". b. Give written notice to us of a claim or "suit' brought against the additional insured including specifics of the claim or "suit" and the date it was received. c. Give written notice of such claim or "suit,' including a demand for defense and indemnity, to any other insurer who had coverage for the claim or "suit" under its policy(les), either at the time of, or at any time subsequent to the occurrence of the 'bodily injury" or "property damage" which is the basis for such claims or 'suit.' ' . (1) Such notification must demand the full coverage available under that policy; and (2) The additional insured shall not take any action to waive or limit such other coverage available to it. GL-4382 (12/04) 1- 4. This insurance does.not apply to: a. ',Bodily injury" or "property damage" resulting from any act or omission of the;additional insured(s) or l .' any of their employees, other than the general supervision of work performed for the additional insured(s) by you; b. "Bodily injury" or "property damage" resulting from "your work" performed on a project where -other valid and collectible insurance is available to the additional insured under an Owner Controlled Insurance Program or Consolidated (wrap-up) Insurance Program; c. 'Bodily injury' or 'property damage' (1) In connection with a project where "your work' .on the project was completed prior to the effective date of this policy, unless the written contract or written agreement includes a specific time requirement for completed operations. coverage to be provided by you for the additional insured for "bodily injury" or 'property damage' occurring during the policy period. (2) In connection with a project where "yourwork".gn the project was completed and where the duration of the additional insured coverage requirement in the written contract or written agreement governing 'your work" on that project had expired by the time that the injury or damage first occurred. (3)In connection with a project where "your work' on the project was completed more than thirty six (36) months prior to the effective data of this policy. For the.purpose of this endorsement, 'your work" will be deemed completed as. set forth in the products -completed operations hazard" definition. d. "Bodily injury" or 'property damage': (1) Arising out of the rendering or failure to render any professional services by.any insured, or on their behalf, but onlywith respect to either or both of the tollowing.operations; (a) Providing engineering, architectural or surveying services,to others in the insured's capacity as an engineer, architect or surveyor, and (b) Providing, or hiring independent professionals to provide, engineering, architectural or surveying services in connection with work the insured performs. (2) Subject to paragraph (3) below, professional services include: (a) The preparing, approving or falling to prepare or approve maps, shop drawings, opinions, reports,. surveys, field orders, change. orders, or drawings and specifications; and (b) Supervisory or inspection activities performed as part of any related architectural or engineering activities, but does not include the general supervision of your operations on such project. (3) Professional services do not include services within construction means, methods, techniques, sequences and procedures employed by you in connection with your operations as a construction contractor. For the purpose of this endorsement, the following definitions are added: 'Owner" means a person or organization who has ownership in the project premises designated in your written contract or written agreement, at which you are performing or performed work. GL-4382 (12/04) -2- "Contractor" means a person or organization with whom you have agreed in a written contract or written agreement to perform work for at the protect designated in the written contract or written agreement "Construction Manager" means a person or organization designated as "construction manager" in your written contract or written agreement, and has management or supervisory responsibilities over "your work' for the protect designated in the written contract or written agreement "Engineer" means a person or organization who has been engaged by the "owner", "contractor" or "construction manager" to perform engineering services for the project designated in your written contract or wntten agreement and has a contractual responsibility for supervising, directing or controlling "your work" on such project "Architect' means a person or organization who has been engaged by the 'owner', 'contractor" or "construction manager' to perform architectural services for the project designated in your written contract or -written agreement and has a contractual responsibility for supervising, directing or controlling "your work" on such project Any coverage provided herein will be excess over any other valid and collectable insurance available to the additional insured(s) whether primary, excess, contingent or on any other basis unless you have agreed in a written contract or written agreement executed prior to any loss that this insurance will be primary However, any insurance specifically purchased for a designated prolect(s), including but not limited to additional insured coverage, owners contractors protective coverage, etc , will be primary with the insurance provided by this endorsement being excess If this insurance is determined to be primary, we agree not to seek contribution from such other insurance only if you have so agreed in the written contract or written agreement In no event will any coverage provided under this endorsement extend beyond the expiration date of this policy GL-4382 (12/04) -3-