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Home My WebLink About380591 J 2 CONTRACTORS - INSURANCE CERTIFICATE (6)ACORD. CERTIFICATE OF LIABILITY INSURANCE 0DATE (MMID 1/26/09DIYYrr) PRODUCER Flood 8r Peterson Insurance Inc 211 First Street Eaton, CO 80615 970 454-3381 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 J2 Contracting Co. 450 East 16th Street; PO Box 129 Greeley, CO 80632 INSURER A: Travelers Insurance Company INSURER B: INSURER C: INSURER D: INSURER E: COVERAGES 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS A GENERAL LIABILITY C0325D6576 01/01/09 01/01/10 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE � OCCUR DAMAGE TO RENTEDPREMISES (Ea occurrence) $300 000 MED EXP (Any one person) $5 000 PERSONAL & ADV INJURY $1 000 000 X PC Ded:2,500 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 PRO- PRO LOC A AUTOMOBILE LIABILITY ANY AUTO 810325D6576 01/01/09 01/01/10 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS X PROPERTY DAMAGE (Per accident) . $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG A EXCESS/UMBRELLA LIABILITY CUP325D6576 01/01/09 01/01/10 EACH OCCURRENCE $4000000 OCCUR CLAIMS MADE AGGREGATE s4,000,000 $ DEDUCTIBLE $ X RETENTION $ 10,000 WORKERS COMPENSATION AND TH- WC STATU- ER EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ** Supplemental Name ** J2 Contracting Co. J-2 Contracting J2 Real Estate LLC (See Attached Descriptions) K I IFIUA I t MULUtK City of Fort Collins 215 North Mason Street 2nd Floor Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 4 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 INSURER, ITS AGENTS OR REPRESENTATIVE ACORD 25 (2001/08) 1 of-3 #M435621 NEK © 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-S (2001/08) 2 of 3 #M435621 DESCRIPTIONS (Continued from Page 1) 1 J2 Equipment Leasing LLC RE: LPATH Berm Erosion Protection Measures, Fort Collins The City of Fort Collins and Anderson Consulting are named as Additional Insured as respects the General Liability only if requred by written contract and coverage applies only as respects to work performed by the Insured for the Additional Insured. AMS 25.3 (2001/08) 3 of 3 #M435621 A, ,CORD- CERTIFICATE OF LIABILITY INSURANCE 0DATE (MM/D 1/26/09D/YYYY) PRODUCER Flood 8r Peterson Insurance Inc 211 First Street Eaton, CO 80615 970 454-3381 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 J2 Contracting Co. 450 East 16th Street; PO Box 129 Greeley, CO 80632 INSURER A: Travelers Insurance Company INSURER B: INSURER C: INSURER D: INSURER E: COVERAGES 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MMIDDIYY LIMITS A GENERAL LIABILITY C0325D6576 01/01/09 01/01/10 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 5XI OCCUR PREMMIS ES I RENTED nc $300 000 MED EXP (Any one person) $5 000 PERSONAL & ADV INJURY $1 000 000 X PD Ded:2,500 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 PRO LOC POLICYFI JECT El A AUTOMOBILE LIABILITY ANY AUTO 810325D6576 01/01/09 01/01/10 COMBINED SINGLE LIMIT (Ea accident) $100,000 0 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG A EXCESSIUMBRELLA LIABILITY CUP325D6576 01/01/09 01/01/10 EACH OCCURRENCE s4,000,000 OCCUR CLAIMS MADE AGGREGATE $4 000 000 $ DEDUCTIBLE $ X RETENTION $ 10 000 WORKERS COMPENSATION AND WC STATLIMITLIMITS US O R EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ** Supplemental Name " J2 Contracting Co. J-2 Contracting J2 Real Estate LLC (See Attached Descriptions) City of Fort Collins 300 Laporte Avenue Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL &I 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 INSURER, ITS AGENTS OR REPRESENTATIVE ACORD 25 (2001/08) 1 of 3 #M435621 NEK O 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 25-5 (2001/08) 2 of 3 #M435621 DESCRIPTIONS (Continued from Page 1) J2 Equipment Leasing LLC RE: LPATH Berm Erosion Protection Measures, Fort Collins The City of Fort Collins and Anderson Consulting are named as Additional Insured as respects the General Liability only if requred by written contract and coverage applies only as respects to work performed by the Insured for the Additional Insured. AMS 25.3 (2001/08) 3 of 3 #M435621