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Home My WebLink About109014 R C HEATH - INSURANCE CERTIFICATE (2)Client#: 25306 orw=A 'ACORD,M CERTIFICATE OF LIABILITY INSURANCE DATE9r3o/oa(,mYYYY) o 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. O. Drawer H Fort Collins, CO 80522 INSURERA: Travelers Insurance INSURER : National Union Fire Insurance INSURERC: Pinnacol Assurance INSURER D: Fireman's Fund Insurance, Co. INSURER 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 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 EFFECTIVE DATE MWOD/YY POLICY EXPIRATION DATE MWDD/YY LIMITS A GENERAL LIABILITY DTCO298N6651- 09/30/04 09/30/05 EACH OCCURRENCE $1 DDOODO X COMMERCIAL GENERAL LIABILITY CLAIMS MADE N OCCUR TIA04 DAMAGETORENTEDPREISES Me occurr n $300DOD MED EXP (Any one Person) $rj 000 X PD Ded:2,500 PERSONAL & ADV INJURY $1 000 DDO GENERAL AGGREGATE $2 DDD OOD GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2000000 POLICY X PRO LOG JECT A AUTOMOBILE LIABILITY ANY AUTO DT810298N6651TIL04 09/30/04 09/30/05 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 T BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS 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 X OCCUR CLAIMS MADE BE2911523 09/30/04 09/30/05 EACH OCCURRENCE s5,000,000 AGGREGATE s5,000,000 $ DEDUCTIBLE X RETENTION $ 10000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 4033691 10/01/04 10/01/05 X WC STATU- H- IT OTR E.L. EACH ACCIDENT $500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYE $SDD,DDD OFFICERIMEMBER EXCLUDED? If yes, describe under E.L. DISEASE - POLICY LIMIT $500,000 SPECIAL PROVISIONS below D OTHER Builders MX198471771 09/30/04 09/30/05 $5M All Other Risk $2.5M Frame $1,000 Ded. $250,000Offsite/Transit DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE:5856 Vehicle Storage Buildings City of Fort Collins, Engineer and Engineer's consultants are named as additional insured, but only as respects liability arising out of work performed by the named insured (Excluding Workers' Compensation). (See Attached Descriptions) City of Fort Collins PO Box 580 Fort Collins, CO 80522 LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3D_ 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 REPRESENT TIVE �t..�LesSO.�.I .�.�f�✓i'.►w�uL ..Ti�C. .+ Umu ca %AUV NDa) 1 of 3 #M296347 JGH © ACORD CORPORATION 1988 r DESCRIPTIONS (Continued from Page 1) 1 Insurance policies do not provide professional liability for architects and engineers. �n�.a 6JN,LVV IIVO/ J VI J iFIY1LyO34/