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Home My WebLink AboutR C HEATH - INSURANCE CERTIFICATE (2)C I ient#: 25306 IarucA r ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE YYYY) 09/30/04 04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4821 Wheaton Drive P O Box 270370 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC # INSURED R.C. Heath Construction Co., Inc. P. Drawer H Fort Collins, CO 80522 INSURERA: Travelers Insurance INSURERB: National Union Fire Insurance INSURERC: Pinnacol Assurance INSURERD: 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 LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY DATE EFFECTIVE POLICY E XPIRATIONMM/DE DATE MMIDD/YYI LIMITS A GENERAL LIABILITY DTCO298N6651- 09/30/04 09/30/05 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 51OCCUR TIA04 DAMAGE TO RENTE�ccuDPREMIS (E. n s300OOO MED EXP (Any one person) s5 000 X PD Ded:2,500 PERSONAL B ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2000000 POLICY X PRO LOC JECT A AUTOMOBILE LIABILITY ANY AUTO DT810298N6651TIL04 09/30/04 09/30/05 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON-OWNEDAUTOS X BODILY INJURY (Per accident) $ X Drive Other Car X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG B EXCESS/UMBRELLA LIABILITY -X1 OCCUR CLAIMS MADE BE2911523 09/30/04 09/30/05 EACH OCCURRENCE s5,000.000 AGGREGATE s5,000,000 XIX RETENTION $ 10000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 4033691 10/01/04 10/01/05 X I TWC STATU- I OTH- E.L. EACH ACCIDENT $500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYEE $500,000 OFFICER/MEMBER EXCLUDED? If yes, describe under E.L. DISEASE - POLICY LIMIT $500,000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE: Warren Park Improvements Project City of Fort Collins, Engineer, Engineer Consultants and their respective officers and employees are named as additional insured, but only as respects liability arising out of work performed by the named insured (See Attached Descriptions) City of Fort Collins PO Box 580 Fort Collins, CO 80522 ACORD 25 (2001/08) 1 of 3 ftM9QR'1Z7 LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL A0_ 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 REPRES IOTA E E G. ,ru L� n Arnon rnoonoAr,nu 40,00 DESCRIPTIONS (Continued from Page 1) 1 (Excluding Workers' Compensation). Insurance policies do not provide professional liability for architects and engineers. t wla ca.a kcvviiUD) 3 OT 3 IVMZU6337