HomeMy WebLinkAboutMOUNTAIN CONSTRUCTORS - INSURANCE CERTIFICATE (5)ACORD CERTIFICA7 OF LIABILITY INSURANC OF ID NZ DATE(MMIDD/YYYY)
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PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Western States Of Colorado HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: EitminouB Insuramas Convany
INSURERS:
Mountain Constructors, Inc. INSURER C:
P.O. BOX 405 INSURER D:
Platteville CO 80651
,.Vucf "Co
THE POLICES 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 POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IN!R
LTR
ADIYL
NSRO
TYPE OF NISURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMMDD
POLICY EIFIRATION
DATE MAID
LMIT$
GENERAL LAELITY
EACH OCCURRENCE
j ZOOOOOO
A
X COMMERCIALGENERALUAINUTY
CLP3170717
07/28/04
07/28/05
PREMA9 ejE.E"oear�«)
$ 100000
AEDE (AM epenm)
f 5000
CLAIMS MADE 41 OCCUR
PERSONAL A ADV INJURY
S 1000000
GENERA -AGGREGATE
j 2000000
GEN-L AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COLP/OPAGG
j 2000000
POLICY F1 JET LOC
AUTOMOBILE
LABILITY
A
ANvwro
CAP3170718 RENEWAL
07/28/04
07/28/05
COMBINED SINGLE LINT
f 1000000
ALLOWNEDAUTOS
BODILYINJURY
j
SCHEDULED AUTOS
(Par Perm)
HIREDAUTOS
BODILYINJURY
j
NON-OWNEDAUTDS
(Pwe d."
PROPERTY DAMAGE
f
(Per BCdtlanl)
GARAGE LABILITY
AUTOONLY-EAACCIDENT
f
Ek AM
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ANY AUTO
OTHERTHAN
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AUTO ONLY: AGG
D(CESENMBIR[LLA LAELRY
EACH OCCURRENCE
j
AGGREGATE
j
OCCUR ❑ CLAIMS MADE
f
f
DEDUCTNNE
f
RETENTION 3
COMPENSATION AND
WORIOYEWLA
WC STATU- OTH-
ST;TS
LABILITY
ILITY
TWC
ER
-
EL. EACH ACCIDENT
j
ANY
ANY PROPRIETORPAATNERIEXECUTNE
OFFICEIRMEMSER EXCLUOED4
I Yes, eMMbeur
E.L. DISEASE -EA EMPLOYEE
f
EL DISEASE- POLICY LINT
$
SPECALPROVISONSW .
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/ VEHICLES I EKCLUMNS ADDED MY WOOReEMENT/ SPECIAL PROVISIONS
-- -,
Certificate Holder and Colorado Department of Transportation are added as`
-
additional insureds for above referenced coverages only as thier interest
AUG 0 9 2004
appears with respect to the North College Ave.& Jefferson Street / Rivers i
Ave. Improvements project.
City of Fort Collins
281 North College Ave.
Fort Collins CO 80522-0580
1 SHOULD ANY OF THE ABOVE DEMCRMED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURERWILL ENOEAVORTO MAIL 30 DAYe WRITTEN
NOTICE TO THE CMRTFICAT! HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LABILITY OFANY KIND UPON THE INSURER ITS AGENTS OR
AUTHORIZED REPREMNTATNE
Jeff Sroviee L-LI.KI TJ"Cu
ACORD 25 (2001/08)