HomeMy WebLinkAboutCUTLER REPAVING - INSURANCE CERTIFICATE (2)_W_ CERTIFICATE OF LIABILITY INSURANCE OP IDCUT - DATE /31/1'18
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#
INSURED
INSURER A. Hartford Underwriters ma Co.
INSURER B: Hartford Fire Insurance Cc 29424
Cutler Repaving Company, Inc. Attn: INSURER C: Twin City Fire Insurance co
921 E.Bob Veskerna 27th Street INSURERD: Cincinnati Insurance Co. _ 10677
Lawrence KS 66046 __..
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWIFDOSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED DR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIO SD OR CH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR
NSR
TYPE OF INSURANCE
POLICYNUMBER
P LICY EFFE TI E
DATE MMIDD/YY
POLTC7EXPIRA I N
DATE MMIDDMI
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$1,000,000
A
X
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FXJ OCCUR
37CQT1562
08/01/08
08/01/09
PREMISES (Ea occurence)
$300,000
MED EXP (Any one person)
$ 10,000
PERSONAL B ADV INJURY
$1,000,000
X
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
Poucv X dEr LOc
PRODUCTS - COMP/OP AGG
$ 2 , 000 , 000
Em Ben.
1,000 000
AUTOMOBILE
LIABILITY
B
ANY AUTO
37UENQT1563
08/01/08
08/01/09
CO
iEaCOMBINED SINGLE LIMIT accident)
$1r00r 0000
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
1
P `
'�-��
�1�'r�7v^
�_.Rr 1�
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
�A�����
�'✓f
Vh'�',-.
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
D
EXCESS/UMBRELLA LIABILITY
X OCCUR �CLAIMSMADE
CCC1152728
JJeed�
08/01/IA
�S
08/01/09
EACH OCCURRENCE
$4,000,000
AGGREGATE
$4,000,000
DEDUCTIBLE
RETENTION $
$
C
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITV
ANV PROPRIETOR/ EXCLUDRIEXECUTIVE
OFFS, ER/MEMBER EXCLUDED?
S yes, tlesPRO ISIO
SPECIAL PROVISIONS below
37WBQT1837
08/01/08
08/01/09
X TORVLIMITS I I ER
E.L. EACH ACCIDENT
$500000
E.L. DISEASE -EA EMPLOYEE
$-5 000
EL DISEASE -POLICY LIMIT
$500000
OTHER
DESCRIPTION OF OPERATIONS 1 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. Maaon St, 2nd Floor PO Box 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Fort Collins CO 80522-0580 REPRESENTATIVES.
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