The URL can be used to link to this page

Home My WebLink AboutJASMA BROS EXCAVATING - INSURANCE CERTIFICATEDATE (MMIDDYYY) ACOR_Q. CERTIFICATE OF LIABILITY INSURANCE OP ID RC JANSM-3 03 26 08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE LBN Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 4848 Thompson Pkwy ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Johnstown CO 80534 Phone:970-635-9400 Fax:970-635-9401 INSURERS AFFORDING COVERAGE NAIC# INSURER A: mountain INSURER B: Pinna Jansma Bros. Excavating ----- ----- & TruckingCorp. INSURERC. 1040 S. Railroad Ave. lNsuRERD: Loveland CO 80537--_----_---- INSURER E: 3�YIR:Idl9�� 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' .......__ ___.... _ _ _ LTR NSR�— TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE PDLICYEX /DDN ) - DATE MMIDDM' DATE MMIDDIVY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL � LIABILITY CLAIMS MADE n l OCCUR CPP0117096 04/01/08 04/01/09 EACH OCCURRENCE -DAMAGETCLRENTE�- PREMISES(Es occurence) $1,000,000 $100,000 MED EXP (Any one person) S 10 r 000 X Blanket Add Il Ins PERSONAL &ADV INJURY $1,000,000 X Blanket Waiver GENERAL AGGREGATE $2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG --- $2,000,000 POLICY PRO- JECT LOC ------ A AUTOMOBILE LIABILITY ANY AUTO BAP0117096 04/01/08 04/01/09 (EaCOMBINED SINGLE LIMIT CO BINEDt) $1rOOOrOO 0 X ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Par person) $ X HIREDAUTOS NON-OWNEDAUTOS ---�-- BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EAACC AUTO ONLY: AGG $ $ A EXCESS/UMBRELLA LIABILITY 30 OCCUR I__ICLAIMSMADE UMB0117096 04/01/08 04/01/09 EACH OCCURRENCE $ 1,000,000 AGGREGATE $1,000,000 -. $ $ DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE 2342390 06/01/07 06/01/08 X TORV LIMITS ER ---- ----- E.L.. EACH ACCIDENT --------- _$-100,000____ OFFICER/MEMBER EXCLUDEDI If yes, describe under EC DI$rNSE - EA EMPLOYEE -------- -- _ $100,000 E.L. DISEASE -POLICY LIMIT $500,000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate holder is listed as additional insured in respects to the General Liability. FORT CO 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 DO SO SHALL City of Fort Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR P.O. Box 580 REPRESENTATIVES. Fort Collins CO 80522 AUT IWAEVRESE01ATIVVjE r.nPDnPATInM 1DAR 4CORo. CERTIFICATE OF LIABILITY INSURANCE OP ID RC DATE(MMIDDIYI'YV) JANSM-3 03 28/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE LBN Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 4848 Thompson Pkwy ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Johnstown CO 80534 Phone:970-635-9400 Fax:970-635-9401 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: nountatn State. Insurance Grp ----------- INSURER 8: Plnnacol Assurance Jansma Bros. Excavating & TruckingCorp. INSURERC 1040 S. Railroad Ave. Loveland CO 80537 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. -- IRSR LTR DOqq NSRtl TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDIVYY POLICY EXPIRATION_ DATE MMIDDNY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 r 000 r 000 A X COMMERCIALGENERALLIABILITY CPP0117096 04/01/08 04/01/09 DAMAUc TU-RENTED PREMISES(Eaoccurrence) -- — $100,000 CLAIMS MADE (-X] OCCUR VIED EXP (Any one person) $ 10,000 _1 X Blanket Add r 1 Ins PERSONAL BADV INJURY $ 1,000,000 X Blanket Waiver GENERAL AGGREGATE s2,000 r 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGO $2r000r000 PRO- POLICY JECT LOC A AUTOMOBILE LIABILITY ANY AUTO RAP0117096 04/01/08 04/01/09 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X X HIRED AUTOS NON-OWNEDAUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ --- GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN . EA ACC $ ANY AUTO $ -_ AUTO ONLY: AGO EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 1 r 000 r 000 A X I OCCUR �CLAIMSMADE UMB0117096 04/01/08 04/01/09 AGGREGATE_ $1,000,000 5 $ DEDUCTIBLE _ $ RETENTION $ WORKERS COMPENSATION AND OTH- X TORY L_IMIT_S B EMPLOYERS' LIABILITY ANY PROPRIETORI PoEXECUTIVE EXCLUDED? OFFICERIMEMBER EXCLUDED? 2342390 06/01/07 06/01/08 _ER E.L. EACH ACCIDENT $ 100,000 ---" - -- ELDISEASE EA EMPLOYEE -- $ 1OO r OOD If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ 500 r 000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Project: City Bonding CERTIFICATE HOLDER CANCELLATION FORT Co 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 DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR City of Fort Collins P.O. BOX 580 REPRESENTATIVES. ALIT IZdb j\E�RESE ATIV_ Fort Collins CO 80522 ACORD 25 (2001/08) OO ACORD CORPORATION 1988