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Home My WebLink AboutCAROLLO - INSURANCE CERTIFICATE (5)ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/05 ROL CAROL10 11 29 05 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Brown & 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 # INSURED INSURER A: Travelers Cas & Surety Co Amer INSURER B: Travelers Lloyds Ins CO. Carollo Engineers P.C. Risk Manement Office ag INSURER C: Great American Insurance Co. 0255 3033 North 44th St #101 Phoenix AZ 85018 INSURER D: 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 ATE (MMIDD IVE PDATE MIDDIYY) CYEXPIRATION LRAITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X X COMMERCIAL GENERAL LIABILITY 630188B39405 12/31/05 12/31/06 PREMISES(Eaoccurence) $500000 CLAIMS MADE XO OCCUR MED EXP (Any one Person) $ 20000 PERSONAL & ADV INJURY $ 1000000 Contractual Li_ ab EXCLUDING PROF LIAB GENERAL AGGREGATE $ 10000000 (SEPERATE POL) GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2000000 POLICY PRO- LOG JECT A AUTOMOBILE LIABILITY ANY AUTO 810995K500805 12/31/05 12/31/06 COMBINED SINGLELlM1T (Ea accident) $ lOOOOOO X BODILY INJURY (Per person) $ B ALL OWNED AUTOS SCHEDULED AUTOS PLCAP995K500805(TX) X BODILY INJURY (Per accident) $ HIREDAUTOS NON -OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 1000000 C X OCCUR CLAIMSMADE TUU5595799 12/31/05 12/31/06 AGGREGATE $ 1000000 Excess of $ Automobil $ DEDUCTIBLE Work Comp $ X RETENTION $10000 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE PACRUB995K342105 12/31/05 12/31/06 X TORY LIMITS I ER E.L. EACH ACCIDENT $ 1000000 E.L. DISEASE - EA EMPLOYE $ 1000000 OFFICERIMEMBER EXCLUDED? H yes describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $1000000 OTHER ADDITIONAL INSURED DOES NOT APPLY TO WORK COMP DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS *Except for 10 Days for Non -Payment of Premium; Except for the Workers Compensation coverage. Re: P972 On Call Professional Electric & Instrumentation Engineering Svcs, Carollo Project No: 7094A.10 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 TYF03 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WALL immommmomAii. 30 * DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, City of Fort Collins, Colorado Attn: James B. O'Neill ASP vE 215 N. Mason St., 2nd Floor Fort Collins CO 80522-0580 ACORD 25 (2001108) 0 ACORD CORPORATION 1988 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. 6300188B39405 Carollo Engineers, '-pe 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 c) This insurance does not apply to "bodily in- to include any person or organization you are re- jury" or "property damage" caused by "your quired to include as an additional insured on this work" included in the "products -completed policy by a written contract or written agreement operations hazard" unless you are required to in effect during this policy period and signed and provide such coverage for the additional in - executed by you prior to the loss for which cover- sured by a written contract or written agree - age is sought. The person or organization does ment in effect during this policy period and not qualify as an additional insured with respect to signed and executed by you prior to the loss the independent acts or omissions of such person for which coverage is sought and then only or organization. The person or organization is for the period of time required by such con - only an additional insured with respect to liability tract or agreement and in no event beyond caused by "your work" for that additional insured. the expiration date of the policy. 2. The insurance provided to the additional insured d) This insurance does not apply to any person is limited as follows: or organization for whom you have procured a) In the event that the limits of liability stated in separate liability insurance while such insu- the policy exceed the limits of liability required ante is in effect, regardless of whether the by a written contract or written agreement in scope or limits of insurance in this policy ex - effect during this policy period and signed and teed those of such other insurance or executed by you prior to the loss for which whether such other insurance is valid or col - coverage is sought, the insurance provided lectable. by this endorsement shall be limited to the 3. Subpart (1)(a) of the Pollution exclusion under limits of liability required by such contract or Paragraph 2., Exclusions of Bodily Injury and agreement. This endorsement shall not in- Property Damage Liability Coverage (Section I — crease the limits stated in Section III — LIMITS Coverages) does not apply to you if the "bodily OF INSURANCE. injury" or "property damage" arises out of "your b) The insurance provided to the additional in- world' performed on premises which are owned or sured does not apply to "bodily injury", "prop- rented by the additional insured at the time "your erty damage", "personal injury" or "advertising work" is performed. injury" arising out of an architect's, engineer's 4. Any coverage provided by this endorsement to an or surveyor's rendering of or failure to render additional insured shall be excess over any other any professional services including: valid and collectible insurance available to the I. The preparing, approving or failing to additional insured whether primary, excess, con - prepare or approve maps, shop drawings, tingent or on any other basis. opinions, reports, surveys, field orders, S. As a condition of coverage, each additional change orders, or drawings and specifi- insured must: cations; and a.) Give us prompt written notice of an p pt y "occur - IL Supervisory or inspection activities per- rence" or offense which may result in a claim formed as part of any related architectural and prompt written notice of "suit". or engineering activities. b.) Immediately forward all legal papers to us, cooperate in the investigation or settlement of CG D2 51 01 03 Copyright, The Travelers Indemnity Company, 2003 Page 1 of 2 COMMERCIAL GENERAL LIABILITY the claim or defense against the "suit," and Ox 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. 011956 Page 2 of 2 Copyright, The Travelers indemnity Company, 2003 CG D2 51 01 03