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HomeMy WebLinkAboutDURAN EXCAVATING - INSURANCE CERTIFICATE (2)Client#: 28315 DUREX ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE 03/30/04Dnvvv) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Ins. Inc. P. O. Box 578 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE 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 Duran Excavating, Inc. INSURER A: CNA Insurance Company INSURERB: Travelers Insurance 418 N. 9th Avenue Greeley, CO 80631 INSURER C: INSURER D: 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 PDATEYMWDD/YYEFFECTIVE POLICY ON DATE MM/DD/YY) LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR X PD Ded:2,000 TCP2068325736 04/09/04 04/09/05 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED $300OOO MED EXP (Any one person) $5 000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG s2,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULEDAUTOS HIREDAUTOS NON -OWNED AUTOS C2068325784 CITY 04//0�y9y/-04� y{ " ((y„ 4 \S/1LiL.lOJ MAR 3 OF FORT 04/09/05 �� 004 CULLINS COMBINED SINGLE LIMIT $1 000 ' rDDU X BODILY INJIURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ A EXCESSIUMBRELLA LIABILITY X OCCUR ❑ CLAIMS MADE FDEDUCTIBLE X RETENTION $ 10000 CUP2068325820 04/09/04 04/09/05 EACH OCCURRENCE $2 OOO OOO AGGREGATE s2,000,000 $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? H yes, describe under SPECIAL PROVISIONS below WC157297117 01/01/04 I 01/01/05 X WCSLIMIT LR- E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYE $1,000,000 E.L. DISEASE -POLICY LIMIT 1$1,000,000 B OTHER Equipment QT6607434A513 04/09/04 04/09/05 Blanket Limit: $822,500 Deductible $2,500 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Project: State Highway 14/Gateway Park Entrance; Bid No. 5550 City of Fort Collins, Engineer and Engineer's Consultant are named as Additional Insured, as their interest may appear. CERT City of Fort Collins P. O. Box 580 Ft Collins , CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CAN( AT REOF, THE ISSUING INSFF MANY EAVOR TO NOTICE TO CERTIFICATE HOLTHE LEFT, IMPOSE NO OBU TION Oq LU181D UPON TI _D BEFORE THE EXPIRATION 'I0_ DAYS WRITTEN FAILURE TO DO SO SHALL SURER ITS AG NTS ACORD 25 (2001/08) 1 of 2 #S2767931M276781 �� v — v DSWY 9 AC♦JORD CORPdRAIWN 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 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. MI Wmu au9 kAvu 1/uoy 2 OT 2 95276793IM276781 ACORD- CERTIFICATE OF LIABILITY INSURANCE YYYY) 3130/MIDD 03130/04 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 CERTIFICATE 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 INSURER A: CNA Insurance Company Duran Excavating, Inc. INSURER B: Travelers Insurance 418 N. 9th Avenue Greeley, CO 80631 INSURERC: INSURER D: 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 MWDDIYY POLICY EXPIRATION DATE MWDDIYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE O OCCUR X PD Ded:2,000 TCP2068325736 04/09/04 04/09/05 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED a300 000 MED EXP (Any one person) $5 000 PERSONAL &ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY ECT M LOC PRODUCTS-COMP/OP AGG $2000000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS C2068325784 ! �a 04/09/04 �x `��`F"'° vvv���7s�`vfift "'^' 31 .2004 OF F01k i aCA'`LINS 04/09/05 — COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY accidentDAMAGE $ GARAGE LIABILITY ANY AUTO AUTO ONLY - FA ACCIDENT $ OTHER THAN FA ACC AUTO ONLY: AGG $ $ A EXCESSAIMBRELLA LIABILITY X OCCUR CLAIMS MADE RDEDUCTIBLE X RETENTION $10000 CUP2068325820 04/09/04 04/09/05 EACH OCCURRENCE s2,000,000 AGGREGATE $2 OOO ODD $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below WC157297117 01/01/04 01/01/05 X I ORWCSTATLI MIT OTH- ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT -1,000,000 B OTHER Equipment QT6607434A513 04/09/04 04/09/05 Blanket Limit: $822,500 Deductible $2,500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS City of Fort Collins is named as Additional Insured, as their interest may appear. I CR1 City of Fort Collins P. O. Box 580 Ft Collins , CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES THEREOF, THE ISSUING INSURER WILL ENDED NOTICE HE CERTIFICATE HO ERN ED TO T IMPOSE NOO GATION OR LI ILITY OFA Y KINE CANCELLED BEFORE THE EXPIRATION R TO MAIL 'A0_ DAYS WRITTEN -EFT, BUT FAILURE TO DO SO SHALL ON THE INSUR R. IT GENTS OR ACORD 25 (2001/08) 1 of 2 #S276792/M276781 `-wInAm I © ACOR RATION 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 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. ^a Wmu Auv tcuu Iluap 2 Ot Z #5276792/M276781