HomeMy WebLinkAboutCUTLER REPAVING - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE OP ID SJ DATE(MMIDD/YYYY)
CUTLE-2 07 31 08
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Johnston Fiss Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
5225 West 75th Street, #200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Shawnee Mission KS 66208
Phone:913-396-0800 Fax:913-396-0835 INSURERS AFFORDING COVERAGE NAIC#
INSURER A: Hartford Underwriters Ins Co.
INSURER B: Hartford Fire Insurance Cc 29424
Cutler Repaving Company, Inc. INSURER C: Twin City rnsurance Co
Attn: Bob Veskerna Y Fire
921 E. 27th Street INSURERD. Cincinnati Insurance Co. 10677
Lawrence KS 66046
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 t _
MAY PERTAIN, THE INSURANCE AFFORDED By THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS bF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR
NSR1.
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFE TIVE
DATE MMIDDDY
POLJ E PIRATI N
DATE MMIOD/YY
LIMITS
A
X
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE O OCCUR
37CQT1562
08/01/08
08/01/09
EACH OCCURRENCE
$1,000,000
DAMACIES(RtNIrence) LU
$300,000
MED EXP (Any one person)
$ 10,000
PERSONAL &ADV INJURY
$1,000,000
X
GENERAL AGGREGATE
$2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY X HECOT 7 LOG
PRODUCTS - COMP/OP AGG
$2,000,000
Emp Ben.
1 000,000
B
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
37UENQT1563
,{)`� %
1 }
l`-1Pt�f'
08/01/08
"..�� (/''
08/01/09
-
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
X
PODI
( accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY:i
ANY AUTO
-%�t�'�•'✓l}:'
'U(
G
fi��
—
AUTO ONLY-EAACCIDENT
$
OTHER THAN EA ACC
AUTOONLYAGO
$1t
$
D
EXCESS/UMBRELLA LIABILITY
X OCCUR CLAIMSMADE
DEDUCTIBLE
RETENTION $
CCC1152728
Jp�y�,
08/01 08
S
08/01/09
EACH OCCURRENCE
s4,000,000
AGGREGATE
$4,000,000
$
$
$
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETORIETOR/PARTNERIEXECUTIVE
OFFICERIMEMBER EXCLUDED?
Uyes, describe under
SPECIAL PROVISIONS below
37WBQT1837
08/01/08
08/01/09
WC STATU
X TORY LIMITS ER
E.L. EACH ACCIDENT
s500000
E. L, DISEASE - EA EMPLOYEE
$SOOOOO
E.L. DISEASE -POLICY LIMIT
$500000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Re: 6077 Hot In Place Recycling Project
The city of Ft. Collins, Colorado is Additional Insured as respects the
general liability
CITYFOR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
City of Fort Collins, CO NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
215 N. Mason St, Ind Floor PO Box 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Fort Collins CO 80522-0580 REPRESENTATIVES,
ACORD 25 (2001/08)
ACORD