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HomeMy WebLinkAboutDELTA CONSTRUCTION - INSURANCE CERTIFICATE (5)ACORU. CERTIFICATE OF LIABILITY INSURANCE i2/22/osD"�Y' 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 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O Box 270370 Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Travelers Insurance Delta Construction of Northern INSURER : Pinnacol Assurance 208 Racquette Drive INSURERc: Fireman's Fund Insurance, Co. Fort Collins, CO 80524 (970) 498-8770 INSURER D: INSURER E: UUV LKAUL5 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 DTC0384P74231ND03 04/30/03 04/30/04 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 51OCCUR DAMAGPREMISE SO RENTEocc.D n $300OOO MED EXP (Any one person) $5 000 X PD Ded:1,000 PERSONAL & ADV INJURY $ j 000 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2000000 POLICY JEC X7 LOC A AUTOMOBILE LIABILITY ANY AUTO DT810384P74231ND03 04/30/03 04/30/04 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS 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 $ AUTO ONLY: AGG A EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMS MADE DTSMCUP384P7423TIL 04/30/03 04/30/04 EACH OCCURRENCE $3000000 AGGREGATE s3,000,000 $ DEDUCTIBLE 1XI RETENTION $ 10000 $ B WORKERS COMPENSATION AND 3298114 07/01/03 07/01104 X WCQRY LIMIT O7H- I ER EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $100,000 _ E.L. DISEASE -EA EMPLOYEE $100,000 OFFICER/MEMBER EXCLUDED? If yes, describe under E.L. DISEASE - POLICY LIMIT $500,000 SPECIAL PROVISIONS below C OTHER Builders MXI98469056 04/30/03 04/30/04 $4,000,000 Limit Risk $200,000 Temp Location $1,000 Deductible DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Re: City of Fort Collins -Moss Rock Wall Certificate holder is named as additional insured. City of Fort Collins Attn: James B O'Neill 11, CPPO, FNIGP 215 North Mason Street 2nd Floor Fort Collins, CO 80524 LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL An DAYS WRITTEN :E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL M NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR ACORD 25 (2001/08) 1 of 2 #S267762/M252906 WXS Z © ACORD CORPORATION 1986