HomeMy WebLinkAboutR C HEATH - INSURANCE CERTIFICATEAC0RDn, CERTIFICATE OF
LIABILITY INSURANCE :::[:�,DATE
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4821 Wheaton Drive
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P O Box 270370
Fort Collins, CO 80527
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURERA: St. Paul Travelers Insurance Company
R.C. Heath Construction Co., Inc.
INSURERB: American International CqpUn
P. O. Drawer H
INSURER C: Pinnacol Assurance
Fort Collins, CO 80522
INSURERD: Fireman's Fund Insuranc , W.
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.
LTRNSR1
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE IMMfDDIM
POLICY EXPIRATION
DATE IMMn)DfYYILIMITS
A
GENERAL LIABILITY
DTCO298N6651TIA-
09/30/05
09/30/06
EACH OCCURRENCE
$1000000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OR OCCUR
05
DAMAGE TO RENTED
MED EXP (Any one person)
$300 000
$5 000
X PD Ded:25,000
PERSONAL & ADV INJURY
$1 00O 000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PET LOC X
PRODUCTS - COMP/OP AGG
$2 00O 000
A
AUTOMOBILE LIABILITY
X ANY AUTO
DT81029BN6651TILOS
09/30/05
09/30106
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per parson)
E
X HIRED AUTOS
X NON -OWNED AUTOS
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
s
GARAGE LIABILfTI'
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGO
E
ANY AUTO
$
B
EXCESSIUMBRELLA LIABILITY
X OCCUR CLAIMS MADE
BE7227730
09/30/05
09/30/06
EACH OCCURRENCE
$S 00O 000
AGGREGATE
s5,000,000
E
E
FDEDUCTIBLE
X RETENTION $10000
$
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
4033691
10/01/05
10/01/06
X WC STATU- OTH-
E.L. EACH ACCIDENT
s5OO OOO
ANY PROPRIETORIPARTNERJEXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
S
SPECIAL PROVISIONS below
E.L. DISEASE - EA EMPLOYEE
$500,000
E.L. DISEASE - POLICY LIMB
$500,000
D
OTHER Builders
MXi 98471771
09130/05
09/30/06
$5,000,000 All Other
Risk
$2,500,000 Frame Only
$1,000 Dad.
$250,000Offsite/Transit
DESCRIPTION OF OPERA71014S I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
RE: Deicing Facility, Bid no 5909
City of Fort Collins, Engineer, Engineer's Consultants respective officers
and employees are named as additional insured, but only as respects
liability arising out of work performed by the named insured (Excluding
(See Attached Descriptions)
City of Fort Collins
Admin Services Purchasing Division
PO Box 580
Fort Collins, CO 80522-0580
LID ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL -In DAYS WRITTEN
:E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
tE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
A nnen ee ,nnn.
U
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DESCRIPTIONS (Continued from Page 1)
Workers' Compensation). Insurance policies do not provide
professional liability for architects and engineers.
AMS 25.3 (2001/08) 3 of 3 #S329565/M327942