HomeMy WebLinkAboutMOUNTAIN CONSTRUCTORS - INSURANCE CERTIFICATE (2)ACORD„ CERTIFICATE OF
LIABILITY
INSURANCE
%zs/2008
PRODUCER (303)824-6600 FAX: (303)370-0118
Mood Insurance Agency, Inc.
Y Yr
3773 Cherry Creek North Drive
Suite 800
Denver CO 80209-3804
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
Mountain Constructors, Inc.
622 Main Street
PO BOX 405
Platteville CO 80651
INSURER A: Bituminous Casualty Corp
02075
INSURERS Pinnacol Assurance
41190
INSURER C:
INSURER D:
INSURER ErOVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING AN
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.
LIMITS SHOWN MAYH I CLAIMS.
INSR
OD'L
TYPEOFINSURANCE
POUCYNUMBER
DATE(MW�UINYYYI VE
?DATE MMIDD/ EXPIRATIONOLICY
LIMITS
A
X
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
I CLAIMS MADE ❑X OCCUR
CLP3255548
Add'l Insured per
Form GL-3088 (01-06)
Attached
7/28/2008
7/28/2009
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
PREMISES Ea o rren
$ lOO,000
MED EXP (Am one ersoa
$ 5,000
PERSONAL SAW INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GENT AGGREGATE
POUCV
LIMIT APPLIES PER:
X JECT LOC
PRODUCTS - COMPIOP AGO
$ 2,000,000
A
AUTOMOBILE
LIABILITY
ANYAUTO
ALLOWNEDAUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
CAP3523564
7/28/2008
7/28/2009
COMBINED SINGLE LIMIT
(Ea accident)
$ 1, UUU,UUU
X
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANYAUTO
AUTO ONLY - EA ACCIDENT
$
OTHERTHAN EA ACC
AUTO ONLY: AGO
$
$
A
EXCESSIUMBRELLA LIABILITY
X OCCUR CI -AIMS
AIMS MADE
DEDUCTIBLE
X RETENTION S 10,000
CUP2583670
7/28/2008
7/28/2009
EACH OCCURRENCE
$2,000,000
AGGREGATE
$ 2,000,00 D
$
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTNE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS PsIrey
3027994
7/1/2008
7/1/2009
X C STATIT OTH-
S ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE -POLICY LIMIT
$ 1,000,000
OTHER
ERATIONWLOCATIONSMEHICLEWEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
287/South College Avenue Bike Lanes
Collins is named as Additional Insured as respects General Liability. 10 Day Notice of Cancellation
n-Payment of Premium This certificate is subject to the terms, conditions, and exclusions of the
F
City of Fort Collins
215 North Mason Street
Fort Collins, CO 80524
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
ACORD 25 (2001/08)
Charlene Navarra, ��LaL,i-c�F•--e_
® 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.
ACORD 25 (2001/08)
INS025Ioioel.oea Pave a az
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
LAND IMPROVEMENT CONTRACTORS
EXTENDED LIABILITY COVERAGE
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
It is agreed that the provisions listed below apply only upon the entry QX in the box next to the caption of
of such provision.
A.
Q
Partnership and Joint Venture Extension
B.
OX
Contractors Automatic Additional Insured
Coverage
C.
0
Automatic Waiver of Subrogation
D.
XQ
Extended Notice of Cancellation, Nonrenewal
E.
XQ
Unintentional Failure to Disclose Hazards
F.
QX
Broadened Mobile Equipment
G.
QX
Personal Injury - Contractual Coverage
H.
XQ
Nonemployment Discrimination
I.
Q
Liquor Liability
J. QX Broadened Conditions
K. QX
Automatic Additional Insureds— Equipment
Leases
L. QX
Insured Contract Extension - Railroad
Property and Construction Contracts
M. EE
Construction Project General Aggregate
Limits
N. XQ
Fellow Employee Coverage
O. ❑X
Property Damage to the Named Insured's
Work
P. XD
Care, Custody or Control
A. PARTNERSHIP AND JOINT VENTURE EXTENSION
The following provision is added to SECTION II - WHO IS AN INSURED:
The last full paragraph which reads as follows:
No person or organization is an insured with respect to the conduct of any current or past partnership,
joint venture or limited liability company that is not shown as a Named Insured in the Declarations.
is deleted and replaced with the following:
With respect to the conduct of any past or present joint venture or partnership not shown as a Named
Insured In the Declarations and of which you are or were a partner or member, you, and others
identified in items 1.e., 1.b., and 1.c., subject to the conditions and limitations contained therein, are
insureds, but only with respect to liability arising out of 'your work' on behalf of any partnership or joint
venture not shown as a Named Insured in the Declarations, provided no other similar liability
insurance is available to you for 'your work" in connection with your Interest in such partnership or joint
venture.
A partnership or joint venture, not shown as a Named Insured in the Declarations, of which you have
33% or more ownership interest at the time of 'bodily injury' or 'property damage' caused by an
'occurrence' or "personal and advertising Injury" caused by an offense, is an insured, provided that no
other similar liability insurance is available to that partnership or joint venture.
GL-30B8 (01/06) -11-
B. CONTRACTORS AUTOMATIC ADDITIONAL INSURED COVERAGE
SECTION 11- WHO IS AN INSURED is amended 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 person(s) or organization(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 part, by your negligence
and with respect to liability resulting from:
A.. Your ongoing operations for the additional insured(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 'suit' seeking damages for *bodily
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.'
2. The Limits of Insurance applicable to the additional insureds under this endorsement are the
minimum limits specified In the written contract or agreement requiring this coverage, or as stated in
SECTION III - LIMITS OF INSURANCE of the COMMERCIAL GENERAL LIABILITY COVERAGE
FORM, whichever is less. These Limits of Insurance are inclusive of and not in addition to the
Limits of Insurance described in SECTION III of that form.
S. 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 "occurrence" or offense took place;
(2) 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.
b. Give written notice to us of a claim or "suit" brought against the additional Insured including
specifics of the claim or 'suit' and the date it was received.
c. Give written notice of such claim or "suit; Including a demand for defense and indemnity, to any
other insurer who had coverage for the claim or "suit' under Its policy(les), either at the 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
(2) The additional insured shall not take any action to waive or limit such other coverage
available to it.
GL-3088 (01/06) -2-
4. This insurance does not apply to:
a. "Bodily injury" 'property damage' or 'personal and advertising injury" occurring after:
l (1) All work on the project (other than service, maintenance, or repairs) to be performed by
you or on your behalf for the additional insured(s) has been completed; or
(2) That portion of 'your work" out of which the injury or damage arises has been put to its
intended use by any person or organization other than another contractor or subcontractor
engaged in performing operations for a principal as a part of the same project.
b. "Bodily injury" 'property damage" or "personal and advertising injury' resulting from any act or
omission of the additional insured(s) or any of their employees, other than the general
supervision of work performed for the additional insured(s) by you.
c. "Bodily injury" 'property damage" or 'personal and advertising injury' resulting from work
performed on a project where other valid and collectible insurance is available to the additional
insured under an Owner Controlled Insurance Program or Consolidated (wrap-up) Insurance
Program.
d. "Bodily injury," "property damage" or "personal and advertising Injury':
(1) Arising out of the rendering or failure to render any professional services by any insured, or
on their behalf, but only with respect to either or both of the following operations;
(a) Providing engineering, architectural or surveying services to others in the insured's
Ccapacity as an engineer, architect or surveyor, and
(b) Providing, or hiring independent professionals to provide, engineering, architectural
or surveying services in connection with work the insured performs.
(2) Subject to paragraph (S) below, professional services include:
(a) The preparing, approving or failing to prepare or approve maps, shop drawings,
opinions, reports, surveys, field orders, change orders, or drawings and
specifications; and
(b) Supervisory or inspection activities performed as part of any related architectural or
engineering activities but does not include the general supervision of your operations
on such project.
(3) Professional services do not include services within construction means, methods,
techniques, sequences and procedures employed by you in connection with your
operations as a construction contractor.
For the purpose of this endorsement, the following definitions are added:
"Owner" means a person or organization who has ownership in the project premises, designated in
your written contract or written agreement, at which you are performing operations.
'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.
GL-3088 (O1/06) -3-
"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 additionalinsured(s) whether primary, excess, contingent or on any 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 other insurance specifically purchased for a designated project(s), including but not
limited to additional insured coverage, owners contractors protective coverage, etc., will be primary with
the insurance provided by this endorsement being excess. If this insurance is determined to be primary,
we agree not to seek contribution from such other insurance only if you have so agreed in the written
contract or written agreement.
C. AUTOMATIC WAIVER OF SUBROGATION
Item S. of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, is deleted and replaced
with the following:
8. Transfer of Rights of Recovery Against Others to Us and Automatic Waiver of Subrogation.
a. If the insured has rights to recover all or part of any payment we have made under this
Coverage Form, those rights are transferred to us. The insured must do nothing after loss to
impair those rights. At our request, the insured will bring "suit" or transfer those rights to us and
help us enforce them. r
b. If required by a written contract executed prior to loss, we waive any right of recovery we may
have against any person or organization because of payments we make for injury or damage
arising out of "your work" for that person or organization.
D. EXTENDED NOTICE OF CANCELLATION, NONRENEWAL
Item A.2.b. of the COMMON POLICY CONDITIONS, is deleted and replaced with the following:
A.2.b. 60 days before the effective date of the cancellation if we cancel for any other reason.
Item 9. of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, is deleted and replaced
with the following:
9. WHEN WE DO NOT RENEW
a. If we choose to nonrenew this policy, we will mail or deliver to the first Named Insured shown in
the Declarations written notice of the nonrenewal not less than 60 days before the expiration
date.
b. If we do not give notice of our intent to nonrenew as prescribed in a. above, it is agreed that you
may extend the period of this policy for a maximum additional sixty(60) days from its scheduled
expiration date. Where not otherwise prohibited by law, the existing terms, conditions and rates
will remain in effect during that extension period. It is further agreed that so long as it is not
otherwise prohibited by law, this one time sixty day extension is the sole remedy and liquidated
damages available to the insured as a result of our failure to give the notice as prescribed in 9.
a. above.
GL-3088 (01/06) -4-