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HomeMy WebLinkAboutIDEAL FENCING - INSURANCE CERTIFICATE (2)ACORD,a CERTIFICATE OF LIABILITY INSURANCE 0DATE JMM/D 9/25/9/25103OrYYYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HRH of Colorado ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 120 S. Colorado Blvd, #600 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 469025 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Denver, CO 80246-9025 INSURERS AFFORDING COVERAGE NAIC 8 INSURED INSURER A: Zurich -American Ins. Co. 31194 Ideal Fencing Corporation INSURER a American Guarantee Insurance 8119 Indian Peaks Ave. Erie, CO 80516 INSURER C: Pinnacol Assurance INSURER E: +VVQ! wCJ 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. NSR LTR ROUT INSRI TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM D/YY POLICY EXPIRATION ATg IMMIDONY)LIMITS A X GENERAL LIABILITY CP03757909 07/01/03 07/01104 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE O OCCUR DAMAGE TO RENTED E300OOO MED EXP (Any one person) $1 O 000 X Ltd Pollution PERSONAL SADVINJURY S1 OOO 000 X Blkt Addl lnsrd GENERAL AGGREGATE s2,000,000 GEWL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 POLICY X JFCT PRO- X LOC A AUTOMOBILE X LIABILRY ANY AUTO CP03757909 07/01/03 07/01/04 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X BODILY INJURY (Par accident) $ X Ltd Pollution X PROPERTYDAMAGE (Per accident) S GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC E ANY AUTO S AUTO ONLY: AGG B EKCESSIUMBRELLA LIABILITY X OCCUR CLAIMS MADE AUC3757910 07/01/03 07/01/04 EACH OCCURRENCE S$ 000 000 AGGREGATE $S 00O 000 S $ DEDUCTIBLE $ RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 4058096 10/01/03 10/01/04 X WC STATU• OTH- E.L. EACH ACCIDENT $500 000 ANY PROPRIETORIPARTNERIEXECUTNE OFFICER/MEMBER EXCLUDED7 S dseerlM under E.L. DISEASE - EA EMPLOYEE 3500 000 E.L. DISEASE - POLICY LIMIT 200 O00 E U1 PROVI31 NS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Project Description: Right of Way License Certificate Holder is an Additional Insured as respects to General Liability only If required by written contract and coverage applies only (See Attached Descriptions) I City of Fort Collins Attn: Engineering Dept. PO Box 580 } Fort Collins, CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL -In, DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVE I Or o 7PJT IUZZU 11917 f yaa4 MAS 0 ACORD CORPORATION 1988 vtirtit�%�1Y..w. h 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. iawnu ca-a tzuuuuat 2 of 3 #5178220/M177984 DESCRIPTIONS (Continued from Page 1) 1 as respects ongoing operations performed by Insured for the Certificate Holder. All coverage terms, conditions and exclusions of the policy apply. Except 10 Days Notice for Non -Payment of Premium and Workers Compensation for any cause of cancellation. AMS 25.3 (2001/08) 3 of 3 #S178220IM177984 POLICY NUMBER: CPO 3757909-00 COMMERCIAL GENERAL LIABILITY CG20371001 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: AS REQUIRED BY WRITTEN CONTRACT Location And Description of Completed Operations: Additional Premium: INCLUDED (If no entry appears above, Information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) Section It — Who Is An Insured Is amended to include as an Insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" at the location designated and described In the schedule of this endorsement performed for that Insured and included in the "products -completed operations hazard". I CG20371001 © ISO Properties, Inc., 2000 AGENT COPY Page 1 of 1