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Home My WebLink About380591 J 2 CONTRACTORS - INSURANCE CERTIFICATE (5)Client# 45027 JTWOC ACORU. CERTIFICATE OF LIABILITY INSURANCE 12/27107DIYYYYI PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Ins Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P O Box 578 HOLDER THIS CERTIFICA rE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW 4687 W 18th Street Greeley, CO 80632 INSURED J2 Contracting Company 450 E ast 16th Street PO Box 129 Greeley, CO 80631 INSURERS AFFORDING COVERAGE INSURERA Travelers Insurance Company NAIC# WSURERB INSURER C INSURER INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED 13ELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REOUIREMEN E TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH l HIS 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 PDATEYMMFDDI YYE POLICY MM/DOYYDN LIMITS A GFNIRAL LIABILITY C079921-9321ND08 01/01/08 01/01109 EACH OCCURRENCE $1000000 ME �� CLAIMS MADE ^I OCCUR TXPD PREMIRGALGENERALLIABILITY DAMAGETORENTED E $300000 MED EXP (Any one person) $5 000 PERSONAL B ADV INJURY $1000000 Dad $2,500 GENERAL AGGREGATE s2,000,000 GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG $2000000 POLICY nPRC TO- Floc E A AUTOMOBILE LIABILITY ANY AUTO 81079921-932TIL08 01/01/08 01101/09 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY i$ ALL OWNED AUTOS SCHEDULED AUTOS (Per person) X BODILY INJURY (Per accident) $ HIRED AUTOS NON OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ _ GARAGE LIABILITY AUTO ONLY EA ACCIDENT S OTHERTHAN EA ACC $ ANYAUTO $ AUTO ONLY AGO A EXCESS/UMBRELLA LIABILITY CUP7992L932TIL08 01/01/08 01/01/09 EACH OCCURRENCE $1000000 X OCCUR CLAIMS MADE AGGREGATE $1 OQQ QOO $ DEDUCTIBLE X RETENTION $$10,000 WORKERS COMPE NSATION AND WC STATU OTH- EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE EL EACH ACCIDENT $ E L DISEASE - EA EMPLOYEE $ OFFICER/MEMBEF EXCLUDED' If yes descnbe undo, SPECIAL PROVISIONS below EL DISEASE -POLICY LIMIT $ A OTHER Equipment 66072251-939 01/01/08 01/01/09 Limit $2,392,791 I Deductible $ 1,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ** Supplemental Name ** J2 Contracting Company J-2 Contracting J2 Real Estate LI_C (See Attached Descriptions) City of Fort Collins 300Laporte Avenue 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 10_. DAYS WRITTEN NOTICE TO I HE 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 AUTHORIZED REPRESENT TIVE �Joont 7 t WJit�edl Z—vg✓rr�✓u1 ,rN�. ACORD 25 (2001/08) 1 of 3 #S402563/M401953 DSM 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) it 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-S (2001)08) 2 of 3 #S402563/M401953 DESCRIPTIONS (Continued from Page 1) 1 J2 Equipment Leasing LLC RE LPATH Berm Erosion Protection Measures, Fort Collins The City of Fort Collins and Anderson Consulting are named as Additional Insured as respects the General Liability only if requred by written contract and coverage applies only as respects to work performed by the Insured for the Additional Insured I_1 di 6'YbYtIPLPi►UI31 Client# 45027 .rTa81 ACORD,. CERTIFICATE OF LIABILITY INSURANCE 12127/0;°""""' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Ins Inc ONLY AND CONFERS NO FLIGHTS UPON THE CERTIFICATE P O Box 578 HOLDER THIS CERTIFICA-fE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW 4687 W 18th Street Greeley, CO 80632 INSURERS AFFORDING COVERAGE NAIC # INSURED J2 Contracting Company 450 East 16th Street PO Box 129 Greeley, CO 80631 INSURER Travelers Insurance Company INSURER B NSURER C INSURER D NSURER 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 NSRE TYPE OF INSURANCE POLICY NUMBER POLICY EFFECIIVE DATE MMIDDP/V POLICY EXPIRATION DATE MM/DO/YV LIMITS A GENERAL LIABILITY C079921-9321ND08 01/01/08 01/01/09 EACH OCCURRENCE $1000000 X I COMMERCIAL GENERAL LIABII ITV CLAIMS MADE FxI OCCUR DREAG EGO REMED rl $300000 MED EXP (Any one person) $5 000 PERSONAL &ADV INJURY $1 OOD 000 TXPDDed $2,500 GENERAL AGGREGATE GEN LAGGFEGATE LIMITAPPLIES PER PRODUCTS COMP/OP AGG 000000 POLCYn PRO- F LOC ETA AUTOMOBILE LIABILITY ANY AUTO 8107992L932TIL08 01/01/08 01/01/09 COMBINED SINGLE LIMIT (Ea accident) [s2,000,000 000,000 X INJURY (Per person) ALL OWNED AUTOSBODILY SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIREDAUTOS NON OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY ALTO $ AUTO ONLY AGG A EXCESS/UMBRELLA LIABILITY CUP79921-932TIL08 01/01/08 01/01/09 EACH OCCURRENCE $1000000 X OCCUR CLAIMS MADE AGGREGATE $1 00O 000 $ DEDUCTIBLE $ X RETENrION $ $10 000 WORKERS COMPE NSATION AND EMPLOYERS LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE WC STATU OTH- S43Y.UTALTS —ER EL EACH ACCIDENT $ EL DISEASE-EAPOEMPLOYE $ OFFICER/MEMBER EXCLUDED' If yes describe under SPECIAL PROVISIONS below EL DISEASE-LICY LIMIT $ A OTHER Equipment 66072251-939 01/01/08 01/01/09 Limit$2,392,791 Deductible $ 1,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ** Supplemental Name ** J2 Contracting Company J-2 Contracting J2 Real Estate LLC (See Attached Descriptions) 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 THERLOF, THE ISSUING INSURLR WILL ENDEAVOR TO MAIL 1D_ DAYS WRITTEN NOTICE TO 1 HE 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 AUTHORIZED REPRESENT�PTIVE ,Fr/6a0( 7, j'eL+rfal St)AJ .L Nf✓r.n,alCA a.�,ial�. ACORD 25 (2001108) 1 Of 3 #S402562/M401953 DSM 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 SUBROGATIONI 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-S (200110B) 2 of 3 #S4025621M401953 DESCRIPTIONS (Continued from Page 1) 1 J2 Equipment Lea -:mg LLC RE LPATH Berm Erosion Protection Measures, Fort Collins The City of Fort Collins and Anderson Consulting are named as Additional Insured as respecls the General Liability only if requred by written contract and coverage applies only as respects to work performed by the Insured for the Additional Insured AMS 25 3 (20MMS) 3 of 3 954U25621M401953