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Home My WebLink About106039 GERRARD EXCAVATING - INSURANCE CERTIFICATEIn Ewing Leavitt Insurance (19706691964) 11 43 09122108GMT-06 Pg 02 03 AGQW-. CERTIFICATE OF LIABILITY INSURANCE 09i22/2008 PRODUCER (970)679-7333 FAX (970)679-7377 Ewing -Leavitt Insurance Agency 4025 St Cloud Dr Suite 100 Loveland CO 80538 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 Gerrard Excavating Inc 1739 S County Rd 13C Loveland CO 80537 INSURERA Bituminous Insurance Co G9081 tNSURERB Pinnacol Assurance INSURERC wSO D INSURER E rnVFRAri FTi 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 ADD t TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION immagirryi LIMITS GENERAL LIABILITY CLP324901S 01/01/2008 01/01/2009 EACH OCCURRENCE $ 1 000 00 X COMMERCIAL GENERAL OBILITY DAMAGE TO RENTED S 100 OD CLAIMS MADE a OCCUR MED EXP (Any one cosscn) $ 10,000 A X BLKT Addl Insureds PERSONAL SADVINJURY $ 1.000.0001 X BLKT Waiver Subrog GENERAL AGGREGATE $ 2 000 00 GENT AGGREGATE LIMIT APPLIES PER 17 POI_ICYF_Xj PRO T F1 LOC PRODUCTS COMPIOP AGG S 2 QQQ 00 AUTOMOBILE LIABILITY X ANY AUTO CAP3518400 01/01/2009 01/01/2009 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 A ALL OWNED AUTOS SCHEOULEDAUTOS X HIRED AUTOS X NUN OWNED AU IUS RODRY INJURY (Per person) $ BODILY INJURY (P MOM) $ PROPERTY DAMAGE (Per accident), $ GARAGE LIABILITY AUTDONLY EAACCIDENT E ANYAUTO OTHEEAACC THAN $ AUTO ON AUTO ONLY qGG $ EXCESSIUMBRELLA LIABILITY OCCUR ❑CLAIMS MADE EACH OCCURRENCE $ AGGREGATE q DEDUCTIBLE s RETENTION $ $ WORKERS COMPENSATION AND 4029598 01/01/2008 01/01/2009 X WC STATV 0TH FIR CRYBLANKET B EMPLOYERS LIABILITY ANY PROPRIETORIPARTNER/EXECUTNE OFFICER/MEMBER EXCLUDED' I yes describe under WAIVER OF SUBROGATION EL EACHACCIBENT $ 11000,000 E L DISEASE EA EMPLOYEEI S 1 000 00 EL DISEASE POLICY LIMn $ 1 000,000 SPECIAL PROVISIONS below A onmercial Inland arine CLP3249015 01/01/2008 O1/01/2009 Leased/Rented Equipment $500 000 limit - $5000 ded DESCRIPTION OF OPERATIONS I LgW TIONS I VEHICLES I E CLUSIONS DED BY DORSEMENTI PECIA PROVISIONS he City of Fort Collins is name as adaitiona� insured wit�T regard to general liability City of Fort Collins 281 N College Ave PO Box 580 Ft Collins CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE ACORD 25 (2001/O81 FAX (970)221-6378 PDF created with FlnePrint pdfFactory trial version www odffactory corn in Ewing Leavitt Insurance (19706691964) 11 43 09122108GMT 06 Pg 03 03 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 AWKU ZO (ZUU7/Ua) PDF created with FinePrint pdfFactory trial version www odffactory com