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Home My WebLink AboutMOUNTAIN CONSTRUCTORS - INSURANCE CERTIFICATE (6)ACORD. CERTIFICATE OF LIABILITY INSURANCE os/28/20 6 PRODUCER (303) 824-6600 FAX (303) 370-0118 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Moody Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 3773 Cherry Creek North Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Y ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite BOO Denver, CO 80209-3804 INSURERS AFFORDING COVERAGE NAIC # INSURED MOUnta in (;onstructors, I nc. PO Box 405 Platteville, CO 80651 COVERAGES INSURERA: Bituminous Insurance Companies INSURER B: P i nnaco I Assurance INSURER C: 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. INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (mmannOM POLICY EXPIRATION DATE (MMMa= LIMITS GENERAL LIABILITY CLP3216240 07/28/2005 07/28/2006 EACHOCCURRENCE $ 1,000,00 X COMMERCIALGENERALLIABILITY DAMAGEPRFMIR TOREMED $ 100,00 CLAIMS MADE [X] OCCUR MED EXP (Any one person) $ 5,000 A PERSONAL BADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,00 X POLICY PROJECT LOC AUTOMOBILE X LIABILITY ANY AUTO CAP3215536 - �`'T 7' ( f('�i, 07/28/2005 07/28/2006 COMBINED SINGLE LIMIT (Ea acadent) $ 1 , 000 , DO A ALLONMEDAUTOS SCHEDULED AUTOS A I\\IlM'. KNZ BODILY INJURY (Per perm) $ BODILY INJURY (Per acddent) $ HIRED AUTOS NON-OWNEO AUTOS ,I��9^ 20U6 20 6 �� ; PROPERTY DAMAGE (Per aoadent) $ i _ Li L- t 'htI7K �� ( COLLj S GARAGE LIABILITY 1 1 AUTO ONLY - EA ACCIDENT $ $ ANY AUTO OTHER THAN EAACC $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 2,000,00 X OCCUR CLAIMS MADE CUP2576738 07/28/2005 07/28/2006 AGGREGATE $ 2,000,00 A $ $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND 3027994 07/01/2006 07/01/2007 X We sTATu- OTH- B EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? E.L EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 It yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Leased/Borrowed Equipment CLP3216240 07/28/2005 07/28/2006 $250,000 per occurrence $1,000 deductible DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS Project: 5931 Mason Street/Harmony Road/Foss i I Creek Bike/Pedestrian Tra i I City of Fort Collins is named additional insured with respect to general liability per attached orm GL4276 9/03. 0 day notice of cancellation applies to non-payment of premium --City of Fort Collins 300 Laporte Ave. Fort Collins. CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT; BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHDRTCED REPRESENTATIVE /L �,..,,., • . _ Charlene Navarra, ACSR/CHAN,` ACORD 25 (2001108) OACORD CORPORATION 1988 JUN 3,; 2; ) CITY OF FOk Y RISK MANAGE: , THIS ENDORSEMENT CHANGES THE POLICY. PLEASE HEAD IT CAREFULLY. CONTRACTORS ADDITIONAL INSURED ENDORSEMENT This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. SECTION M - WHO III AN INSURED Is atnar 4 to Include: Any 'owner, "contractor", "construction manager", 'engineer' or 'architect" if it is required in your written contract or written agreement executed by you and all other parties to the contract or agreement prior to any loss that such parson(s) or orgenlzation(s) be added as an additional insured on your policy but only for the project designated In your written contract or written agreement and only with respect to 'bodily Injury,' property damage' or'personal and advertising injury' caused, at least in pan, by your negligence and with respect to liability resulting from: A. Your ongoing opaistions for the sddhional insurad(s), or S. Acts or omissions of the additional insured(s) in connection with their general supervision of such operations. With respect to the insurance afforded such additional insureds pursuant to this endorsement and the above referenced General Liability Form, the following additional provisions apply to limit that coverage: 1. We will have no duty to defend the additional insured against any "suri" seeking damages for 'bodlly injury,' property damage' or 'personal and advertising injury' until we receive written notice from the additional insured requesting that we defend It in the 'suit.* 3. The Limits of Insurance applicable to the additional Insureds under this endorsement are those specified in the written contract or agreement requiring this coverage, or as stated in SECTION M- LIMITS OF INSURANCE of the COMMERCIAL GENERAL LIABILRY COVERAGE FORM, whichever are less. These Limits of Insurance are inclusive of and not In addition to the Limits of Insurance described in SECTION ■ of that forth. 3. As additional conditions of coverage under this form, an additional insured under this endorsement will as soon as practicable: a. Give written notice to us of an 'occurrence' or an offense which may result in a claim. This shall include: (1) How, when and where the 'occurrance' or offense took place: M The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence' or offense. It. Give written notice to us of a claim or 'suit' brought against the additional insured including specifics of the claim or'suft- and the date it was received. m Give written notice of such claim or "suit,' including a demand for defense and indemnity, to any other Insurer who had coverage tot the claim of'suft' under its poi cy(les), either at flue time of, or at any time subsequent to the occurrence of the 'bodily injury,' 'property damage' and/or the offense causing the 'personal and advertising injury,' which is the basis for such claims or *suit'. (1) Such notification must demand the full coverage available under that policy; and GL-4276 (09/03) -1- 'Contractor" means a person or organization with whom you have agreed in a written contract or written agreement to perform operations for at the project designated in the written contract or written agreement. 'Construction Manager" means a person or organization designated as 'construction manager" In your written contract or written agreement, and has management or supervisory responsibilities over your operations for the project designated In your written contract or written agreement. "Engineer" means a person or organization who has been engaged by the 'owner", 'contractor' or 'construction manager" to perform engineering services for the project designated in your written contract or written agreement and has a contractual responsibility for supervising, directing or controlling your operations on such project. "Architect- means a person or organization who has been engaged by the 'owner". 'contractor" or 'construction manager' to perform architectural services for the project designated In your written contract or written agreement and has a contractual responsibility for supervising, directing or controlling your operations on such project. Any coverage provided herein will be excess over any other valid and collectable insurance available to the additional Insured(s) whether primary, excess, contingent or on arty other basis unless you have agreed in a written contract or written agreement executed prior to any loss that this insurance will be primary. However, any Insurance specifically purchased for a designated pro)ect(s), Including but not limited to spadfic additional insured coverage, owners contractors protective coverage, etc., will be primary with this insurance being excess. This insurance will be noncontributory only If you have so agreed In a written contract or written agreement executed prior to any loss and this coverage is determined to be primary. OL-4276 (09/03) -3-