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HomeMy WebLinkAbout113109 WATERFORD CORPORATION - INSURANCE CERTIFICATE (5)r g; INSURED: WATERFORD CORPORATION 404 NORTH LINK LANE FORT COLLINS CO 80524 ENDORSEMENT: Waiver Of Subrogation 7501 E Lowry Blvd Denver, CO 80230-7006 Phone. (303) 361-4000 / (800) 873-7242 Fax:(303) 361-5000 /(888) 329-2251 NCCI #: WC000313 Policy #: 4105522 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. SCHEDULE Fort Collins -Loveland Municipal Airport 4900 Earhardt Road Loveland CO 80538 Effective Date: August 25, 2008 Expires on June 1, 2009 Pinnacol Assurance has issued this endorsement August 25, 2008. Kelsey Caldwell Underwriter Pinnacol Assurance"7501 E Lowry Elvd'Denver, C080230 Paget d3 PINNAWEB- EA.rnal/EMP Record Onl 08125120081146'.41 4105522 Updated. 02;01/2007 UW137 ®Q-Q- fir" CERTIFIC ' TE OF LIABILITY INSIJR° WE PINNACOL ASSURANCE THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION ONLY 7501 E Lawry Blvd AND CONFERS NO RIOHTD UPON THE CERTIFICATE HOLDER. 7'1-113 Denver CO 90230-7006 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE IxevF.ER, PINNACOL ASSURANCE 41190 VVATERFORD CORPORATION _ 404 NORTH LINK LANE �aFe� FORT COLLINS. CO 90526 IF!s„REF, �. ovrrncec THE POLICIES OF INSURANCE LISTED BELOW HAVEBEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHS.TANDNG ANY REOUIRCUENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER OOCUMMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLJCIEP. DESCRIBED HEREIN I�. UBJEC-f TO ALL THE TERW.. EKCLU.ION: AND CONOITIOrv:OP.5,UC,` POLICIES. LIMIT' SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS. �O.o.E5C Cc F �D' CE TO kcCT£R C'vivs o_cuc t PF .I I _ — FEF<OIynL 1041:1JJF:Y ' r� -..rc u..rtn'Cl M1[^ c [n. rc.\ % GPOD�i'CTc.'LOCIF:OF nCC o O'CY °FNE.•I ' I p e'oraeltE OAEILITr COMP!d:E] I"Cc nvr4`. o r v✓n �i'}F_'i•""r" 9CHE0'JLEJ nV'O; RRE01070: I POCLL.Y.PpOF,Y n . rO,VMEO "—as i IF I, a ;ir•l __ FROPEFTY DAI,-cE c n IrvONLY'EEn QAe I.JAnc CCIOci•! T F CE a 81UW P E LLA ILIA 61111Y I E,cF OCO'JFkamiciz ! CIE occ,e: I� CW bI_'unOE `K-CF.EFn TF I FE'EAT!ON d � �w r j 3'n r'� �_�crnC^. cOnc Cn Dnr�On nno 1i �'rt'G ! EMFLOYEA S 1481111 ' nnY FEOFF ETogFn .. JF%"cC'JTn.F 4105622 001011200E ON 01'2006 E_ nCM nCC DENT' OF Fl CERIM EIII PEF EXCWOE0 L omE,.FA.=n c.m n,II s as 'lt 4FELInvRO. 0 [ . '. I ._. i E�D«aE. FOUCY UMrt ' I I OE6CR:RTON OF OOERATONS/LOCATONSIVBHICLES e%CLVSIONS MOEO EY ENOORS EMENTIWEOV4 PPOVISIONS The Cities of F! Collins and Loveland Are naIYFd SE adeti OIIGI 160re(I re9Pr(LnO I)reject FOIL Collins & Loveland MOOIcipal Airport:Arport SOCVrity orproVITIOats Alp Project #3-06-002323 1102242 Fort Collino.Lovelen(I Monbipsl Airport 490D zm,hnrt Rand Loveland CO 2053 E CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EAPIRATION DATE THEREOF. THE ISSUING COMPANY WILLENDEAVOR 'f MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO Tv LEFT. BUT FAILURE TO MAIL SUCH NOTICE °HALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITP, AGENTP OR REPRE3ENTATIVE3. AUIIiORIZED REPRESENTATIVE Kelsey CalUWell .CORD 25(2001/08) Untle,oInter ACORD CORPORATION 193"0 POLICY HOLDER COPY WATERFORD CORPORATION 404 NORTH LINK LANE FORT COLLINS, CO80524 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. ,ArO CERTIFICATE OF ��ABILITY INSURANCE oa/oi2ou ff"Y ROOUCER (970) 223-0924 FAX (97 .67-2231 THIS CERTIFICATE IS, JED AS A MATTER OF INFORMATION Colorado DW Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1075 IJ Horsetooth Rd, Ste ].06 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fort Collins, CO 80526 — 1 Watert,ord Corporation 404 N Link Lane Fort Collins, CO 8OS24 COVFRAGFS INSURERS AFFORDING COVERAGE I NAIC # INSURERA: Auto -Owners Insurance INSURER B. INSURER C: INSURER D: INSURER E THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVIATHSTAN DING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VVITH 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 CC' flSH TYPE OF INSURANCE. POLICY NUMBER POLICY EFFECTIVE .IdiN.!➢ALYY.7 POLICY EXPIRATION _ DAIF: I.MMmnn LIMITS GENERAL LIABILITY 74005303 07/01/2008 07/01/2009 EACHOCCURRENCE S 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR DAMAGE TO RENTED PRF=-SJEecr n,mnrnl_ .MEO E%P (Any one parson) $ 3OO,000 $ 10,000 A PERSONAL & ADV INJURY _ S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OPAGG $ 2,000,000 X I POLICY PRO- JEC7 LOC -, AUTOMOBILE LIABILITY ANY AUTO 4513177806 07/01/2009 07/01/2009 COMBINED SINGLE LIMIT (Ea amdonl) $ 1,000,000 X A ALL OVrNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ BODILY INJURY (Per accidenl) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Par accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EAACC AUTO ONLY: AGO $ ANY AUTO S EXCESS/UMBRELLA LIABILITY 4513177807 07/01/2008 07/01/2009 EACH OCCURRENCE $ 1,000,000 -XI OCCUR CLAIMSMADE AGGREGATE $ 1,000,00 A s S DEDUCTIBLE X RETENTION 3 10,00 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR)PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? WC STATU- OTH- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMP40YEE $ Il yes, daealba untlor SPECAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ A OTHER Leased and Rented Equipment 74005303 07/01/2008 07/01/2009 $100,000 with $1000 Deductible Actual Cash Value DESC RIPTION OF OPERATIONS I LOCATIONS IVEHICLES/EXCLUSION ADDED BY ENDORSEMENT I SPECIAL PROM IONS The City of Fort Collins and the City o Loveland are named as additional insureds with respect to the ongoing activities of the named insured. Reference: AIP Project No. 3-08-0023-23 Bid Package No. 1 Security Fencing and Security Gate Improvements Ft Coll ins -Loveland Municipal Airport 4900 Earhardt Rd Loveland, CO 80538 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 MAII. SUCH NOTICE SHALT- IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES, AUTHORIZED REDFQLNTATIVE / ACORD 26 (2001/08) 61 ©ACOP/) 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 26 (2001/08)