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HomeMy WebLinkAboutDIAMOND EXCAVATING INC - INSURANCE CERTIFICATEChant!! 51923 8DIAMEXC ACORU. CERTIFICATE OF LIABILITY INSURANCE 10112J07 PRODUCER HRH of Colorado 720 South Colorado Boulevard 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. Suite 60ON Denver, CO 80246 INSURERS AFFORDING COVERAGE NAIC # INSURED Diamond Excavating, Inc 5940 W 59th Avenue Arvada, CO 80003 INSURERA Bituminous Casualty Corp 20095 INSURERS Pinnacol Assurance 41190 NSURER C INSURER D INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN fSSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH 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 INSRrMIMERCIALGENERAL DIDF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDDIYY POLICY EXPIRATION DATE MMIDDIYY LIMITS ABILITY CLP3246770 10/16/07 10/16/08 EACH OCCURRENCE $1 000 000 CIALGENERAL LIABILITY IMS MADE � OCCUR DAMAGE TO rce $too000 MED EXP (Any one person) $10 000 PERSONAL & ADV INJURYs1 000 000 d 1 000 GENERAL AGGREGATE $2 00O 000 5 0106 G ATE LIMIT APPLIES PER PRODUCTS COMPOP AGG 52000000 X JECOT LOC A AUTOMOBILE LIABILITY ANY AUTO CAP3516726 10/16/07 10/16/08 COMBINED SINGLE LIMIT (accident) $1,000,oOO X BODILY INJURY (Per person) S ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIRED AUTOS NON OWNED AUTOS X X PROPERTY DAMAGE (Per accident) $ Drive Other Car _ GAR AGE LIABILITY AUTOONLY EAAOCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY AGG A EXCESS/UMBRELLA LIABILITY CUP2581735 10/16/07 10/16/08 EACH OCCURRENCE $5 000 000 X OCCUR CLAIMS MADE AGGREGATE S51000.000 $ $ DEDUCTIBLE Is X RETENTION b 1O o0O B WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE 2296640 04/01/07 04/01108 X I WCSTATU OTH T IMIT R EL EACH ACCIDENT $1,0w000 EL DISEASE EA EMPLOYEE 51,000,000 OFFICER/MEMBER EXCLUDED? If Yes describe under SPECIAL PROVISIONS below E L DISEASE POLICY LIMIT $1,000 Ooo OTHER DESCRIPTION OF OPERATIONS[ LOCATIONS/ VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Project Description Right of Way Contractor License The following are Additional Insureds as respects General Liability only if required by written contract and coverage applies only as (See Attached Descriptions) City of Fort Collins P O Box 580 Fort Collins, CO 80522 SHOULD ANY OFT HE ABOVE DESCRIE ED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL —sn 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 REPRESENTATIVE ACORD 25 (2001/08) 1 of 3 #M556012 8JPAE O 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 msuier(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 ACORn ze_s rsnnvneu � s 4 «K, ...�,� DESCRIPTIONS (Continued from Page 1) respects ongoing operations performed by the Insured for the Additional Insureds Additional Insureds City of Fort Collins All coverage terms, conditions and exclusions of the policy apply The Additional Insured endorsement which is referenced above under "Type of Insurance -General Liability" is attached This Certificate of Insurance represents coverage currently in effect and may or may not be in compliance with any written contract * 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 HIviD LO 4 kzUU lluti) 3 Or 3 SMbbbUIZ B. CONTRACTORS AUTOMATIC ADDITIONAL INSURED COVERAGE SECTION II - 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 but only for the project designated in your written contract or written agreement and only with respect to "bodily injury," "property damage" or "personal and advertising injury" caused, at least in part, by your negligence and with respect to liability resulting from - A. Your ongoing operations for the additional insured(s), or B. Acts or omissions of the additional insured(s) in connection wrih their general supervision of such operations. With respect to the insurance afforded such additional insureds pursuant to this endorsement and the above referenced 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," "property damage" or "personal and 'advertising injury," 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. 1 3. As additional conditions of coverage under this forms an, additional insured under this endorsement will as soon as practicable: .�• r a. Give written notice to us of an "occurrence" or an offense which may result in a claim. This shall include (1) How, when and where the "occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses, and (3) The nature and location of any injury or damage ansing out of the "occurrence" or offense. b. Give written notice to us of a claim or "suit" brought against the additional insured including specifics of the claim or "sun' and the date it was received Give written notice of such claim or "sun," including a demand for defense and indemnity, to any other insurer who had coverage for the claim or "suil" under its policy(ies), either at the time of, or at any time subsequent to the occurrence of the "bodily injury," "property damage" and/or the offense causing the "personal and advertising injury," which is the basis for such claims or "suit" (11) Such notification must demand the full coverage available under that policy, and ,f" der (2) The additional insured shall not take any action to waive or limit such other coverage available to it GL-3085 (01/06) -2- 4. This insurance does not apply to a. "Bodily injury" "property damage" or "personal and advertising injury" occurring after (1) All work on the project (other than service, maintenance, or repairs) to be performed by you or on your behalf for the additional insured(s) has been completed, or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project b. "Bodily injury" "property damage" or "personal and advertising injury" resulting from any act or omission of the additional insured(s) or any of their employees, other than the general supervision of work performed forthe additional insured(s) by you c. "Bodily injury" "property damage" or "personal and advertising injury" resulting from work perlormed 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 d. "Bodily injury," "property damage" or "personal and advertising injury" (1) Arising out of the rendering or failure to render any professional services by any insured, or on their behalf, but only with respect to either or both of the following operations, (a) Providing engineering, architectural or surveying services to others in the insured(s capacity as an engineer, archifect"orsurveyor, and (b) Providing, or hiring independent professronals 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 failing 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 contractor written agreement, at which you are performing operations "Contractor" means a person or organization with whom you have agreed in a written contract or written agreement to perform operations for at the project designated in the written contract or written agreement GL-3085 (01/06) -3- "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 operations for the project designated in your 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 written agreement and has a contractual responsibility for supervising, directing or controlling your operations 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 operations 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 other insurance specifically purchased for a designated project(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 contractor written agreement COMMERCIAL GENERAL LIABILITY CG 20 33 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IF CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section If — Who Is An Insured is amended to include as an additional insured any person or or- ganizabon for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an addi- tional insured on your policy. Such person or or- ganization is an additional insured only with re- spect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by 1. Your acts or omissions, or 2. The acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the additional insured A person's or organization's status as an additional insured under this endorsement ends when your operations for that additional insured are com- pleted B With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply This insurance does not apply to 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the render- ing of, or the failure to render, any professional architectural, engineering or surveying ser- vices, including - a. The preparing, approving, or failing to pre- pare or approve, maps, shop drawings, opinions, reports, surveys, Feld orders, change orders or drawings and specifica- bons, or b. Supervisory, inspection, architectural or engineering activities 2, "Bodily injury' or "property damage" occurring after a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than ser- vice, maintenance or repairs) to be per- formed by or on behalf of the additional in- sured(s) at the location of the covered operations has been completed, or b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontrac- tor engaged in performing operations for a principal as a part of the same project CG 20 33 07 04 © ISO Properties, Inc , 2004 Page 1 of 1 0