Loading...
HomeMy WebLinkAboutALLIANCE CONSTRUCTION - INSURANCE CERTIFICATEACORD. CERTIFICATE OF LIABILITY INSURANCE 12/27`/2007 PRODUCER (303)824-6600 FAX: (303)370-0118 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION NLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Moody Insurance Agency, g y• Inc.. HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 3773 Cherry Creek North Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Suite 800 Denver CO 80209-3804 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER Travelers Indemnity 25658 Alliance Construction Solutions INSURERS Travelers Pxop Cas Cc of 25674 2725 Rocky Mountain Ave INSURER cAmer Guarantee Liab Ins 26247 Ste 100 INSURER Pinnacol Assurance 141190 Loveland CO 80538 INSURER EFireman's Fund Ins Co 121873 THE POLICIES OF INSURANCE LISTED 13ELOW 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 ADD'L INSIPID TYPE OF INSURANCE POLICY NUMBER PDATE YMWDD/YYE POLICY MM/DD/YEXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO TED PREMISES (Ea olccurrrence $ 300,000 rA X COMMERCIAL GENERAL LIABILITY CLAIMS MADE Fx_] O(CUR DTC0016IL68AIND08 1/1/2008 1/1/2009 VIED EXP (Any oneperson) S 5.000 PERSONAL & ADV INJURY $ 11000,000 _ GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTSCOMP/OP AGG $ 2,000,000 POLICY X J 0 UDC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Eaacadent) $ 1,000,000 X BODILY INJURY (Per person) $ B ALL OWNED AUTOS SCHEDULED AUTOS DT8100161L68ATIL08 l/l/2008 l/l/2009 BODILY INJURY (Per accident) $ HIRED AUTOS NON OWNED AUTOS PROPERTY DAMAGE (Per accident) $ Comp Ded: $500 _ Coll Ded: $500 GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 10, 000, 000 X OCCUR CLAIMS MADE AGGREGATE S 10, 000, 000 S $ C DEDUCRBLE AUC914113800 l/l/2008 l/l/2009 X RETENTION $ 0 D WORKERS COMPENSATION AND X WC STATU O7H FR EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ 500,000 E L DISEASE - EA EMPLOYEE $ 500,000 OFFICER/MEMBER EXCLUDED? 4038468 1/l/2008 1/l/2009 O Yes, describe under SPECIAL PROVISIONS below EL DISEASE -POLICY LIMIT S 500,000 ry OTHER guilders Risk MZI98473110 l/1/2008 l/l/2009 Single Location: 10,000,000 Frame Only: 2,500,000 Deductible: 5,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Re: Northside Aztlan Center Propsal #P983 Replacement of existing facility @ 112 E. willow St., Ft. C City of Ft. Collins is named as additional insured with regards to general liability for work performed by the named insured per form CGD248 8/05. By State Law, 10 days notice of cancellation for non-payment of premium --City of Fort Collins Purchasing Division 215 North Madison Ave. Ft. Collins, CO 80521 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 ACORD 25 (200i/08) INS025 (0108) 00a AUTHORIZED REPRESENTATIVE L Ransom, CIC, CPCU/J © ACORD CORPORATION 1988 Page 1 of IMPORTANT If the certificate holder Is an ADDITIONAL INSURED, the policy(les) 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 (o108) 08a Page 2 of 2 IMPORTANT If the certificate holder Is an ADDITIONAL INSURED, the policy(les) 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 (o108) 08a Page 2 of 2 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 (2001108) Page 2 of 2 INS025 (otoa) oaa COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (CONTRACTORS OPERATIONS) This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED — (Section II) is amended c) The insurance provided to the additional in- to include any person or organization that you sured does not apply to "bodily injury" or agree in a "written contract requiring insurance" "property damage" caused by "your work" to include as an additional insured on this Cover- and included in the "products -completed op - age Part, but erations hazard" a) Only with respect to liability for "bodily injury", 3. The insurance provided to the additional insured "property damage" or "personal injury", and by this endorsement is excess over any valid and b) If, and only to the extent that, the injury or collectible "other insurance", whether primary, damage is caused by acts or omissions of excess, contingent or on any other basis, that is you or your subcontractor in the performance available to the additional insured for a loss we _ of "your work" to which the "written contract cover under this endorsement However, if the requiring insurance" applies The person or "written contract requiring insurance" specifically organization doers not qualify as an additional requires that this insurance apply on a primary insured with respect to the independent acts basis or a primary and non-contributory basis, or omissions of such person or organization this insurance is primary to "other insurance" available to the additional insured which covers 2. The insurance provided to the additional insured that person or organization as a named insured by this endorsement is limited as follows for such loss, and we will not share with that a) In the event that the Limits of Insurance of "other insurance" But the insurance provided to this Coverage Part shown in the Declarations the additional insured by this endorsement still is exceed the limits of liability required by the excess over any valid and collectible "other in - .,written contract requiring insurance", the in- surance", whether primary, excess, contingent or surance provided to the additional insured on any other basis, that is available to the addi- shall be limited to the limits of liability re- tional insured when that oerson or organization is quired by that "written contract requiring in_ an additional insured under such "other insur- surance" This endorsement shall not in- ance" crease the limits of insurance described in 4. As a condition of coverage provided to the Section III — Limits Of Insurance additional insured by this endorsement _ b) The insurance provided to the additional in- a) The additional insured must give us written sured does not apply to "bodily injury", "prop- notice as soon as practicable of an "occur- erty damage" or "personal injury" arising out rence" or an offense which may result in a of the rendering of, or failure to render, any claim To the extent possible, such notice professional architectural, engineering or sur- should include veying services, Including i. How, when and where the "occurrence" i The preparing, approving, or failing to or offense took place, prepare or approve, maps, shop draw- ii. The names and addresses of any injured ings, opinions, reports, surveys, field or- persons and witnesses, and ders or change orders, or the preparing, approving, or failing to prepare or ap- iii The nature and location of any injury or prove, drawings and specifications, and damage arising out of the "occurrence" or ii Supervisory, inspection, architectural or offense engineering activities CG D2 48 08 05 0 2005 The St Paul Travelers Companies, Inc Page 1 of 2 COMMERCIAL GENERAL LIABILITY b) If a claim is made or "suit' is brought against the additional insured, the additional insured must i Immediately record the specifics of the claim or "suit' and the date received, and n. Notify us as soon as practicable The additional insured must see to it that we receive written notice of the claim or "suit' as soon as practicable c) The additional insured must immediately send us copies of all legal papers received in connection with the claim or "suit', cooperate with us in the investigation or settlement of the claim or defense against the "suit', and otherwise comply with all policy conditions d) The additional insured must tender the de- fense and indemnity of any claim or "suit' to any provider of "other insurance" which would cover the additional insured for a loss we cover under this endorsement However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to 'other insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above 5 The following definition is added to SECTION V — DEFINITIONS "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal injury" is caused by an offense committed a After the signing and execution of the contract or agreement by you, b. While that part of the contract or agreement is in effect, and c. Before the end of the policy period 4 Page 2 of 2 © 2005 The St Paul Travelers Companies, Inc CG D2 48 08 05 ACORD.. CERTIFICATE OF LIABILITY INSURANCE iaii7/200�' PRODUCER (303)824-6600 FAX: (303)370-0118 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Moody Insurance Agency, Inc. HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 3773 Cherry Creek North Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Suite 800 Denver CO 80209-3804 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER Travelers Indemnity 25658 Alliance Construction Solutions INSURER B Travelers Prop Cas Co of 25674 2725 Rocky Mountain Ave INSURER cAmer Guarantee Liab Ins 26247 Ste 100 INSURER D Pinnacol Assurance 41190 Loveland CO 80538 INSURER E Fireman I s Fund Ins Co 21873 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 I-Il SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DDNY POLICY EXPIRATION DATE MM/DDNY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 DAMAGE TO RENTED PREMISES Ea re occurnce $ 300, 000 X COMMERCIAL GENERAL LIABILITY MED EXP (Any oneperson) $ 5,000 A 7 CLAIMSMADE rX1 OCCUR DTCO0161L68AIND08 1/1/2008 1/1/2009 PERSONAL&ADV INJURY $ 1,000,000 _ GENERAL AGGREGATE $ 2,000,000 GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,000 RO- POLICY X PE T LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ 8 ALL OWNED AUTOS SCHEDULED AUTOS DT810016IL68ATILOS l/l/2008 l/l/2009 BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ Comp Ded: $500 _ Coll Ded: $500 GARAGE LIABILITY AUTOONLY EAACCIDENT $ OTHER THAN EA ACC ANY AUTO $ AUTO ONLY AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10, 000, 000 X OCCUR ]CLAIMS MADE $ C DEDUCTIBLE AUC914113800 l/l/2008 1/1/2009 X RETENTION 0 D WORKERS COMPENSATION AND WCATTH X OR LIMIT- ER E L EACH ACCIDENT $ 500,000 EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E L DISEASE - EA EMPLOYEES 500,000 OFFICER/MEMBEREXCLUDED9 4038468 1/1/2008 1/1/2009 If yes, describe under SPECIAL PROVISIONS below E L DISEASE -POLICY LIMIT S 500, 000 E OTHER guilders Risk MZI98473110 l/1/2008 l/l/2009 Single Location 10,000,000 Frame Only: 2,500,000 Deductible: 5,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: Fort Collins Transit Center at the Lory Student Center on the Colorado State University Carrel City of Fort Collins is named as an Additional Insured under the General Liability per attached iorm CGD248 8/05 as respects the above project. A Waiver of Subrogation is added to the General Liability in favor of the City of Fort Collins. 10 days notice of cancellation for non-payment of premium --City of Fort Collins 215 North Mason St. 2nd Floor Fort Collins, CO 80524 ACORD 25 (2001/08) INS025 (0108) o8a CANCELLATION 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 INSURER, ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE L Ransom, CIC, CPCU/J © ACORD CORPORATION 1988 Page 1 of 2 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the polfcy(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 fnsurer(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 ACUHu 25 (2UU1/08) Page 2 of 2 INS025 foioef oaa COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (CONTRACTORS OPERATIONS) This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART 1 WHO IS AN INSURED — (Section II) is amended c) The insurance provided to the additional in- to include any person or organization that you sured does not apply to "bodily injury" or agree in a "written contract requiring insurance" "property damage" caused by "your work" to include as an additional insured on this Cover- and included in the "products -completed op - age Part, but erations hazard" a) Only with respect to liability for "bodily injury", 3. The insurance provided to the additional insured "property damage" or "personal injury", and by this endorsement is excess over any valid and b) If, and only to the extent that, the injury or collectible "other insurance", whether primary, damage is caused by acts or omissions of excess, contingent or on any other basis, that is you or your subcontractor in the performance available to the additional insured for a loss we _ "your work„ " to which the written contract cover under this endorsement However, if the .written re quiring insurance" applies The person or re contract requiring insurance" specifically organization does not qualify as an additional requires that this insurance apply on a primary Insured with respect to the independent acts basis or a primary and non-contributory basis, or omissions of such person or organization this insurance is primary to "other insurance" available to the additional insured which covers 2 The insurance provided to the additional insured that person or organization as a named insured by this endorsement is limited as follows for such loss, and we will not share with that a) In the event that the Limits of Insurance of "other insurance" But the insurance provided to this Coverage Part shown in the Declarations the additional insured by this endorsement still is exceed the limits of liability required by the excess over any valid and collectible "other in - "written contract requiring insurance", the in- surance", whether primary, excess, contingent or surance provided to the additional insured on any other basis, that is available to the addi- shall be limited to the limits of liability re- tional insured when that person or organization is quired by that "written contract requiring in- an additional insured under such "other insur- surance" This endorsement shall not in- ance" crease the limits of insurance described in 4 As a condition of coverage provided to the Section III — Limits Of Insurance additional insured by this endorsement _ b) The insurance provided to the additional in- a) The additional insured must give us written sured does not apply to "bodily injury", "prop- notice as soon as practicable of an "occur- erty damage" or "personal injury" arising out rence" or an offense which may result in a of the rendering of, or failure to render, any claim To the extent possible, such notice professional architectural, engineering or sur- should include, veying services, including i. How, when and where the "occurrence" i The preparing, approving, or fading to or offense took place, prepare or approve, maps, shop draw- ii. The names and addresses of any injured ings, opinions, reports, surveys, field or- persons and witnesses, and ders or change orders, or the preparing, approving, or failing to prepare or ap- Ili The nature and location of any injury or prove, drawings and specifications, and damage arising out of the "occurrence" or ii Supervisory, inspection, architectural or offense engineering activities CG D2 48 08 05 © 2005 The St Paul Travelers Companies, Inc Page 1 of 2 COMMERCIAL GENERAL LIABILITY b) If a claim is made or "suit' is brought against the additional insured, the additional insured must i Immediately record the specifics of the claim or "suit' and the date received, and n. Notify us as soon as practicable The additional insured must see to it that we receive written notice of the claim or "suit' as soon as practicable c) The additional insured must immediately send us copies of all legal papers received in connection with the claim or "suit', cooperate with us in the investigation or settlement of the claim or defense against the "suit', and otherwise comply with all policy conditions d) The additional insured must tender the de- fense and indemnity of any claim or "suit` to any provider of "other insurance" which would cover the additional insured for a loss we cover under this endorsement However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to 'other insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above 5 The following definition is added to SECTION V — DEFINITIONS "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal injury" is caused by an offense committed; a After the signing and execution of the contract or agreement by you, b. While that part of the contract or agreement is in effect, and c. Before the end of the policy period Page 2 of 2 © 2005 The St Paul Travelers Companies, Inc CG D2 48 08 05 ACORD. CERTIFICATE OF LIABILITY INSURANCE 12128/2007' PRODUCER (303)824-6600 FAX: (303)370-0118 Moody Insurance Agency, Inc. 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 Alliance Construction Solutions, LLC Alliance Equipment, Co. RLLLP 2725 Rocky Mountain Ave, Ste 100 Loveland CO 80538 INSURER A Travelers Indemnity 25658 INSURERB Travelers Prop Cas Co of 25674 NSURERcAmer Guarantee Liab Ins 26247 INSURERDPinnacol Assurance 41190 INSURPRE 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 A GREG TE LIMIT SHOWN MAY HAVE BEEN REDUCED BY PAID AIM INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMDDNV POLICY EXPIRATION DATE MM/DDNVi LIMITS GENERAL LIABILITY EACH OCCURRENC S 1,000,000 DAMAGE PREMISES .occurence $ 300,000 A X COMMERCIAL GENERAL LIABILITY CLAIMSMADE OCCUR DTC00161L68AIND08 1/l/2008 l/l/2009 MED EXP (Any one erson $ 5,000 PERSONAL& ADV INJURY $ 1,000, 000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS COMP(OP AGG $ 2,000,000 POLICYI �L I JEOT I LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ B ALL OWNED AUTOS SCHEDULED AUTOS DT8100161L68ATIL08 1/l/2008 1/l/2009 BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUl OS PROPERTY DAMAGE (Per accident) S _ GAR AGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ANY AUTO $ AUTO ONLY AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 10, 000, 000 X OCCUR CLAIMS MADE AGGREGATE $ 10, 000, 000 $ C DEDUCTIBLE AUC914113800 1/l/2008 1/l/2009 S X RETENFION S 0 D WORKERS COMPENSATION AND X WC STATU- I OTH- rR EMPLOVERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ 500,000 EL DISEASE - EA EMPLOYEE$ 500,000 OFFICER/MEMBEREXCLUDED9 It yes, describe under SPECIAL PROVISIONS below 4038468 l/l/2008 1/l/2009 EL DISEASE -POLICY LIMIT $ 500,000 g OTHER Scheduled Equipment: QT66094695043TIL08 1/1/2008 1/1/2009 Limit: 523,150 Business Personal Limit: 206,000 Property Deductible: 1,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: Ground Lease IS Fort Collins/Loveland Airport City of Fort Collins is named Additional Insured in regards to General Liability per attached form CGD248 08/05. By State Law, 10 days notice of cancellation for non-payment of premium --City of Fort Collins PO BOX 580 Fort Collins, CO 80522-0580 CANCELLATION 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 IHE 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 REPRESENTATIVES AUTHORIZED REPRESENTATIVE Ransom, CIC, CPCU/J ACORD 25 (2001/08) INS025 (0100) 0Ba © ACORD CORPORATION 198E Page 1 of, ACORD. CERTIFICATE OF LIABILITY INSURANCE 12128/2007' PRODUCER (303)824-6600 FAX: (303)370-0118 Moody Insurance Agency, Inc. 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 Alliance Construction Solutions, LLC Alliance Equipment, Co. RLLLP 2725 Rocky Mountain Ave, Ste 100 Loveland CO 80538 INSURER A Travelers Indemnity 25658 INSURERB Travelers Prop Cas Co of 25674 NSURERcAmer Guarantee Liab Ins 26247 INSURERDPinnacol Assurance 41190 INSURPRE 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 A GREG TE LIMIT SHOWN MAY HAVE BEEN REDUCED BY PAID AIM INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMDDNV POLICY EXPIRATION DATE MM/DDNVi LIMITS GENERAL LIABILITY EACH OCCURRENC S 1,000,000 DAMAGE PREMISES .occurence $ 300,000 A X COMMERCIAL GENERAL LIABILITY CLAIMSMADE OCCUR DTC00161L68AIND08 1/l/2008 l/l/2009 MED EXP (Any one erson $ 5,000 PERSONAL& ADV INJURY $ 1,000, 000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS COMP(OP AGG $ 2,000,000 POLICYI �L I JEOT I LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ B ALL OWNED AUTOS SCHEDULED AUTOS DT8100161L68ATIL08 1/l/2008 1/l/2009 BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUl OS PROPERTY DAMAGE (Per accident) S _ GAR AGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ANY AUTO $ AUTO ONLY AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 10, 000, 000 X OCCUR CLAIMS MADE AGGREGATE $ 10, 000, 000 $ C DEDUCTIBLE AUC914113800 1/l/2008 1/l/2009 S X RETENFION S 0 D WORKERS COMPENSATION AND X WC STATU- I OTH- rR EMPLOVERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ 500,000 EL DISEASE - EA EMPLOYEE$ 500,000 OFFICER/MEMBEREXCLUDED9 It yes, describe under SPECIAL PROVISIONS below 4038468 l/l/2008 1/l/2009 EL DISEASE -POLICY LIMIT $ 500,000 g OTHER Scheduled Equipment: QT66094695043TIL08 1/1/2008 1/1/2009 Limit: 523,150 Business Personal Limit: 206,000 Property Deductible: 1,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: Ground Lease IS Fort Collins/Loveland Airport City of Fort Collins is named Additional Insured in regards to General Liability per attached form CGD248 08/05. By State Law, 10 days notice of cancellation for non-payment of premium --City of Fort Collins PO BOX 580 Fort Collins, CO 80522-0580 CANCELLATION 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 IHE 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 REPRESENTATIVES AUTHORIZED REPRESENTATIVE Ransom, CIC, CPCU/J ACORD 25 (2001/08) INS025 (0100) 0Ba © ACORD CORPORATION 198E Page 1 of,