HomeMy WebLinkAboutDURAN EXCAVATING - INSURANCE CERTIFICATE (3)ACORDnw CERTIFICATE
OF LIABILITY INSURANCE
DAT2(MMIDDIYYYY)
12l20l03
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood 8, 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.
INSURERB: Travelers Insurance
418 N. 9th Avenue
Greeley, CO 80631
INSURER C:
INSURER D:
INSURER E:
WGIVA d [L•TN MW
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 (MWDD/YYI
POLICY EXPIRATION
DATE MMIDD/YY
LIMITS
A
GENERAL LIABILITY
TCP2068325736
04/09/03
04/09/04
EACH OCCURRENCE
$ j 0QQ 000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE F-R OCCUR
DAMAGE TO RENTEDPREMISE no.,
a300 000
$$ 000
MED EXP (Any one person)
PERSONAL & ADV INJURY
$1,000,000
GENERAL AGGREGATE
s2000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$Z 00O 000
POLICY PET LOC
A
AUTOMOBILE
LIABILITY
ANY AUTO
C2068325784
04/09/03
04/09/04
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
-
HIRED AUTOS
NON -OWNED AUTOS
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
S
AUTO ONLY: AGG
A
EXCESS/UMBRELLA LIABILITY
X OCCUR CLAIMS MADE
CUP2068325820
04/09/03
04/09/04
EACH OCCURRENCE
$5 000 000
AGGREGATE
s5,000,000
$
$
RDEDUCTIBLE
$
X RETENTION $ 10000
A
WORKERS COMPENSATION AND
WC157297117
01/01/04
01/01/05
X WC STATU- OTH-
EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA EMPLOYEE
$1,000000
OFFICERIMEMBER EXCLUDED?
N yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE -POLICY LIMIT
$1,000,000
B
OTHER Equipment
OT6607434A513
04/09/03
04/09/04
Blanket Limit:
$1,051,500
Deductible $1,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONSg
Project: State Highway 14/Gateway Park Entrance; Bid No. 5550
+gi���n1D
.�1Ll��ll(iryry��CC��1J-
City of Fort Collins, Engineer and Engineer's Consultant are named as
Additional Insured, as their interest may appear.
DEC 2 3 2003
City of Fort Collins
P. O. Box 580
Ft Collins , CO 80522-0580
LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THEEkAIRATIO
THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO ///M���AIL -In DAYS WRITTEN
1.1'6,jHE CERTIFICATE HOLD NAMED THE LEFT T FAILURE TO DQ SC SHALL
iE NO O GATION Olt LIABI TY OF ANY KI UPON T INSURER, ITS A/GGEEE OR
a
ACORD 25 (2001/08) 1 of 2 #S267606/M267595 DSMA (4ACORD CORPORATION 1988