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HomeMy WebLinkAboutCAROLLO - INSURANCE CERTIFICATE (3)ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID H DATE(MMIDDIYYYY) CAROL10 1 06 28 05 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Brown S Brown Insurance of AZ ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2800 N. Central Ave., #1600 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 2800 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phoenix AZ 85002-2800 Phone: 602-277-6672 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Travelers Cas 6 Surety Co Amer INSURER B Travelers Lloyds Ins CO Carollo Engineers P.C. Risk Managgement Office INSURER Travelers d InemnitY Cc of C2T 2568 3033 North 44th St #101 _ _ -- _ Phoenix AZ 85018 INSURERD Great American Insurance Co. 0255 - — — —- -- - 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 MMIDDNY POLICYEXPIRATION- --- __- _ - -- DATE MMIDDIYY LIMITS GENERAL LIABILITY I EACH OCCURRENCE $ 1000000 A X X COMMERCIAL GENERAL LIABILITY 630018BB39404 12/31/04 12/31/05 — $ 500000 j�3NAGE TO RENTED -MEMISES(Ea occurence) CLAIMS MADE j OCCUR MED EXP (Any one person) $ 20000 Contractual Liab EXCLUDING PROF LIAB PERSONAL & ADV INJURY $1000000 - GENERAL AGGREGATE $ 10000000 (SEPERATE POL) [GEN'L AGGREGATE LIMIT APPLIES PER: IPRODUCTS- COMP/OP AGG $2000000 POLICY FRCOT LOC AUTOMOBILE LIABILITY ! COMBINED SINGLE LIMIT A X ANY AUTO 810995K500804 12/31/04 12/31/05 (Ea accident) $ 1000000 B ALL OWNED AUTOS CAP995K5008 (TEXAS) BODILY INJURY SCHEDULED AUTOS (Per person) $ X - X HIRED AUTOS NON-OWNEDAUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ tPer accident) GARAGE LIABILITY - AUTO ONLY - EA ACCIDENT $ $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 1000000 D XOCCUR �l CLAIMSMAOE TUU5595799 12/31/04 12/31/05 AGGREGATE $ 1000000 Excess of $ $ DEDUCTIBLE Automo_bil Work Comp $ X RETENTION $ 10000 WORKERS COMPENSATION AND X TORY LIMITS ER C EMPLOYERS' LIABILITY UB995K342104 12/31/04 12/31/05 E.L. EACH ACCIDENT $1000000 ANY PROPRIETOR/PARTNERIEXECUTIVE - -- DISEASE-EA EMPLOYEE [EL. — -. $1000000 OFFICERIMEMBER EXCLUDED? If yes. describe underSPECIALPROVISIONSbelow DISEASE -POLICY LIMIT $ 1000000 OTHER ADDITIONAL INSURED DOES:1 NOT APPLY TO NOM COMP DESCRIPTION OF OPERATIONS / LOCATIONS] VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS *Except for 10 Days for Non -Payment of Premium; Except for the Workers Compensation coverage. Re: P972 On Call Professional Electric 6 Instrumentation Engineering Svcs, Carollo Project No. not yet assigned. City of Fort Collins, its officers and employees are named as additional insured as respects to the General Liability per form CGD251(01/03). CERTIFICATE HOLDER CANCELLATION CI TYFO3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOP DATE THEREOF, THE ISSUING INSURER WILL — MAIL 30 * DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, City of Fort Collins, Colorado Attn: James B. O'Neill 215 N. Mason St., 2nd Floor Fort Collins CO 80522-0580 ACORD 25 (2001108) ©ACORD CORPORATION 1988 630018883940:4 6aralla 8agitaaorllk, F+O, COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART COMMERCIAL GENERAL LIABILITY -CONTRACTORS COVERAGE PART 1. WHO IS AN INSURED — (Section II) is amended to include any person or organization you are re- quired to include as an additional insured on this policy by a written contract or written agreement in effect during this policy period and signed and executed by you prior to the loss for which cover- age is sought. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. The person or organization is only an additional insured with respect to liability caused by "your work" for that additional Insured. 2. The insurance provided to the additional insured Is limited as follows: a) In the event that the limits of liability stated in the policy exceed the limits of liability required by a written contract or written agreement in effect during this policy period and signed and executed by you prior to the loss for which coverage is sought, the insurance provided by this endorsement shall be limited to the limits of liability required by such contract or agreement. This endorsement shall not in- crease the limits stated in Section III — LIMITS OF INSURANCE. b) The insurance provided to the additional in- sured does not apply to "bodily injury", "prop- erty damage", "personal injury" or "advertising injury" arising out of an archited's, engineer's or surveyor's rendering of or failure to render any professional services including: 1. The preparing, approving or falling to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifi- cations; and It. Supervisory or inspection activities per- formed as part of any related architectural or engineering activities. CG D2 51 01 03 c) This insurance does not apply to "bodily In- jury" or "property damage" caused by "your work" included in the "products -completed operations hazard" unless you are required to provide such coverage for the additional, in- sured by a written contract or written agree- ment in effect during this policy period and signed and executed by you prior to the loss for which coverage is sought and then only for the period of time required by such con- tract or agreement and in no event beyond the expiration date of the policy. d) This insurance does not apply to any person or organization for whom you have procured separate liability insurance while such insur- ance is in effect, regardless of whether the scope or limits of insurance in this policy ex- ceed those of such other insurance or whether such other insurance is valid or col- lectable. 3. Subpart (1)(a) of the Pollution exclusion under Paragraph 2., Exclusions of Bodily Injury and Property Damage Liability Coverage (Section 1 — Coverages) does not apply to you if the "bodily injury" or "property damage" arises out of "your work" performed on premises which are owned or rented by the additional insured at the time "your work" is performed. 4. Any coverage provided by this endorsement to an additional insured shall be excess over any other valid and collectible insurance available to the additional insured whether primary, excess, con- tingent or on any other basis. 5. As a condition of coverage, each additional insured must: a.) Give us prompt written notice of any "occur- rence" or offense which may result in a claim and prompt written notice of "suit". b.) immediately forward all legal papers to us, cooperate in the investigation or_setdoment.of _.._ Copyright, The Travelers Indemnity Company, 2003 Page 1 of 2 COMMERCIAL GENERAL LIABILITY the claim or defense against the "suit" and otherwise comply with policy conditions.. c.) Tender the -defense and indemnity of any claim or "suit" to any other insurer which also insures against a loss we cover under this endorsement. This Includes, but is not limited to, any insurer which has Issued a policy of Insurance in which the additional insured qualifies as an insured. For purposes of this requirement, the term "Insures against" refers to any self-insurance and to any insurer which Issued a policy of Insurance that may provide coverage for the loss, regardless of whether the additional insured has actually requested that the insurer provide the additional insured With a defense and/or indemnity under that policy of insurance. d.) Agree to make available any other insurance that the additional Insured has for a loss we cover under this endorsement. Page 2 of 2 Copyright, The Travelers Indemnity Company, 2003 CG D2 51 01 03