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Home My WebLink AboutHIGH COUNTRY PIPELINE - INSURANCE CERTIFICATE (3)ACORD. CERTIFICATE OF LIABILITY INSURANCE 09/22/05 DIYYYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Van Gilder Insurance Corp (CS) ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 24 South Weber HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Colorado Springs, CO 80903 719 634-8807 INSURED High Country Pipeline Contractors, Inc P.O. Box 208 Penrose, CO 81240-0208 I:UVCKALitJ INSURERS AFFORDING COVERAGE NAIC # INSURERA: Bituminous Insurance Companies INSURER B: National Union Fire Ins Co of Pitts INSURER C: Pinnacol Assurance INSURER D: INSURER E: 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 INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDDIYY POLICY EXPIRATION DATE MM/DD/YV LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR X PD Ded: $1,000 CLP3218450 09/25/05 09/25/06 EACH OCCURRENCE $1 00Q 000 DAMAGE SO ECQFD a $300 000 MED EXP (Any one person) $5 000 PERSONAL & ADV INJURY $1 00D 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 7X JECD� 7 LOC PRODUCTS - COMP/OP AGG s2,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CAP3501079 09/25/05 09/25/06 COMBINED SINGLE LIMIT (Ea accident) $1,DDD,DDD BODILY INJURY (Perperson) $ X X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ B EXCESSIUMBRELLA LIABILITY X OCCUR CLAIMS MADE DEDUCTIBLE X RETENTION $ 1 U 000 BE9033699 09/25/05 09/25/06 EACH OCCURRENCE $5 00D 000 AGGREGATE $5 000 000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 4014538 10/01/05 10/01/06 STATU- OTH- TORY = 1.. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEd $1,000,000 E.L. DISEASE -POLICY LIMIT 1$1.000.000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS 10 Day written notice of cancellation for non-payment. Certificate issued to provide evidence of coverage. RE: Fort Collins Utilities ------------- City of Fort Collins, Water Utilities Attn: Project Manager P.O. Box 580 Fort Collins, CO 80522 LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1D_ DAYS WRITTEN :E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL iE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR ACORD 25 12nn'I/nA1 4 —c 4 "RA InlC-1I, REPRESENTATIVE