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357129 NARANJO CIVIL CONSTRUCTORS INC - INSURANCE CERTIFICATE (3)
ACORD CERTIFICATE OF LIABILITY INSURANCE 2DATE /18/2009Y) PRODUCER (303)824-6600 FAX: (303)370-0118 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Moody Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 3773 Cherry Creek North Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 800 Denver CO 80209-3804 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Bituminous Casualty Corp 02075 Naranjo Civil Constructors, Inc. INSURER B:Pi.nnacol Assurance 41190 INSURER C: H&L Concrete, Inc. INSURER D: 1863 2nd Avenue INSURER E: Greeley CO 80631 OVERAGES 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. AGGREGAT N MA HAVE BEE 4 REDUCED BY PAID CLAIMS. INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE PREM SESOER occur ence $ 100,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FXI OCCUR CLP3261599 2/18/2009 2/18/2010 MEDEXP An oneperson) $ 5,000 PERSONAL BADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 Additional Insured Form GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OPAGG $ 2,000,000 #GL 3084 01-06 attahced POLICY X PRO LOC AUTOMOBILE LIABILITY X ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ A ALL OWNED AUTOS SCHEDULED AUTOS CAP3528228 2/18/2009 2/18/2010 BODILY INJURY (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EAACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 1,000,000 X OCCUR CLAIMS MADE AGGREGATE $ 1,000,000 $ A DEDUCTIBLE CUP2584983 2/18/2009 2/18/2010 X RETENTION $10.000 $ WORKERS COMPENSATION AND - X WC STATU- OTHLIMITS I I ER EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 11000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 1452910 6/l/2008 6/l/2009 E.L. DISEASE - POLICY LIMIT $ 1,000,000 A OTHER Installation Floater CLP3261599 2/18/2009 2/18/2010 Limit: $30,000 Deductible: $1, 000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: 6082 Horsetooth - Ziegler Roundabout and Ziegler Road Improvements - Proj. #6082 City of Ft. Collins, its Servants, agents, citizens and employees are listed as additional insured under the General Liability. This insurance is primary. Contractual liability is included. A waiver of subrogation applies in favor of the same with regards to the general liability when required by written contract. This certificate is subject to the terms, conditions, and exclusions of the policies. A 10-day notice of cancellation will apply in the event of City of Fort Collins 215 North Mason Street 2nd Floor Fort Collins, CO 80524 TION 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 DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE C Smith, CISR, CRIS/G � ACORD 25 (2001/08) INS025 (0108).08a © ACORD CORPORATION 1988 Page 1 of 2 ,-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. AGVHU 25 (zwl/os) Page 2 of 2 INS025 (0108).08a COMMENTS/REMARKS non-payment of premium. OFREMARK COPYRIGHT 2000, AMS SERVICES INC. A partnership or joint venture, not shown as a Named Insured in the Declarations, of which you have 33% or more ownership interest at the time of "bodily injury" or "property damage" caused by an "occurrence" or "personal and advertising injury" caused by an offense, is an insured, provided that no other similar liability insurance is available to that partnership or joint venture. B. CONTRACTORS AUTOMATIC ADDITIONAL INSURED COVERAGE SECTION II - WHO IS AN INSURED is amended to Include: Any "owner", "contractor", "construction manager", "engineer" or "architect" if it is required in your written contract or written agreement executed by you and all other parties to the contract or agreement prior to any loss that such person(s) or organization(s) be added as an additional insured on your policy but only for the project designated in your written contract or written agreement and only with respect to "bodily injury," "property damage" or "personal and advertising injury" caused, at least in part, by your negligence and with respect to liability resulting from: A. Your ongoing operations for the additional insured(s), or B. Acts or omissions of the additional insured(s) in connection with their general supervision of such operations. With respect to the insurance afforded such additional insureds pursuant to this endorsement and the. above referenced General Liability Form, the following additional provisions apply to limit that coverage: 1. We will have no duty to defend the additional insured against any "suit" seeking damages for "bodily injury," "property damage" or "personal and advertising injury," until we receive written notice from the additional insured requesting that we defend it in the "suit." 2. The Limits of Insurance applicable to the additional insureds under this endorsement are the minimum limits specified in the written contract or agreement requiring this coverage, or as stated in SECTION III - LIMITS OF INSURANCE of the COMMERCIAL GENERAL LIABILITY COVERAGE FORM, whichever is less. These Limits of Insurance are inclusive of and not in addition to the Limits of Insurance described in SECTION III of that form. 3. As additional conditions of coverage under this form, an additional insured under this endorsement will as soon as practicable: a. Give written notice to us of an 'occurrence" or an offense which may result in a claim. This shall include: (1) How, when and where the "occurrence" or offense took place; (2) The names and addresses of any injured persons and witnesses; and (3) The nature and location of any injury or damage arising out of the "occurrence" or offense. b. Give written notice to us of a claim or "suit' brought against the additional insured including specifics of the claim or "suit" and the date it was received. c. Give written notice of such claim or "suit," including a demand for defense and indemnity, to any other insurer who had coverage for the claim or "suit" under its policy(ies), either at the time of, or at any time subsequent to the occurrence of the "bodily injury," "property damage" and/or the offense causing the "personal and advertising. injury," which is the basis for such claims or "suit'. (1) Such notification must demand the full coverage available under that policy; and GL-3084 (01/06) -2- (2) The additional insured shall not take any action to waive or limit such other coverage available to it. 4. This insurance does not apply to: a. "Bodily injury" "property damage" or "personal and advertising injury" occurring after: (1) All work on the project (other than service, maintenance, or repairs) to be performed by you or on your behalf for the additional insured(s) has been completed; or (2) That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. b. "Bodily injury" "property damage" or "personal and advertising injury" resulting from any act or omission of the additional insured(s) or any of their employees, other than the general supervision of work performed for the additional insured(s) by you. c. "Bodily injury" "property damage" or "personal and advertising injury" resulting from work performed on a project where other valid and collectible insurance is available to the additional insured under an Owner Controlled Insurance Program or Consolidated .(wrap-up) Insurance Program.. d. "Bodily injury," "property damage" or "personal and advertising injury": (1) Arising out of the rendering or failure to render any professional services by any insured, or on their behalf, but only with respect to either or both of the following operations; (a) Providing engineering, architectural or surveying services to others in the insured's capacity as an engineer, architect or surveyor, and (b) Providing, or hiring independent professionals to provide, engineering, architectural or surveying services in connection with work the insured performs. (2) Subject to paragraph (3) below, professional services include: (a) The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; and (b) Supervisory or inspection activities performed as part of any related architectural or engineering activities, but does not include the general supervision of your operations on such project. (3) Professional services do not include services within construction means, methods, techniques, sequences and procedures employed by you in connection with your operations as a construction contractor. For the purpose of this endorsement, the following definitions are added: "Owner" means a person or organization who has ownership in the project premises, designated, in your written contract or written agreement, at which you are performing operations. "Contractor" means a person or organization with whom you have agreed in a written contract or written agreement to perform operations for at the project designated in the written contract or written agreement. GL-3084 (01/06) -3- "Construction Manager" means a person or organization designated as "construction manager" in your written contract or written agreement, and has management or supervisory responsibilities over your operations for the project designated in your written contract or written agreement. "Engineer" means a person or organization who has been engaged by the "owner", "contractor" or "construction manager" to perform engineering services for the project designated in your written contract or written agreement and has a contractual responsibility for supervising, directing or controlling your operations on such project. "Architect" means a person or organization who has been engaged by the "owner", "contractor" or "construction manager" to perform architectural services for the project designated in your written contract or written agreement and has a contractual responsibility for supervising, directing or controlling your operations on such project. Any coverage provided herein will be excess over any other valid and collectable insurance available to the additional insured(s) whether primary, excess, contingent or on any other basis unless you have agreed in a written contract or written agreement executed prior to any loss that this insurance will be primary. However, any other insurance specifically purchased for a designated project(s), including but not limited to additional insured coverage, owners contractors protective coverage, etc., will be primary with the insurance provided by this endorsement being excess. If this insurance is determined to be primary, we agree not to seek contribution from such other insurance only if you have so agreed in the written contract or written agreement. C. AUTOMATIC WAIVER OF SUBROGATION Item 8. of SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, is deleted and replaced with the following: 8. Transfer of Rights of Recovery Against Others to Us and Automatic Waiver of Subrogation. a. If the insured has rights to recover all or part of any payment we have made under this Coverage Form, those rights are transferred to us. The insured must do nothing after loss to impair those rights. At our request, the insured will bring "suit' or transfer those rights to us and help us enforce them. b. If required by a written contract executed prior to loss, we waive any right of recovery we may have against any person or organization because of payments we make for injury or damage arising out of "your work" for that person or organization. D. EXTENDED NOTICE OF CANCELLATION, NONRENEWAL Item A.2.b. of the COMMON POLICY CONDITIONS, is deleted and replaced with the following: A.2.11b. 60 days before the effective date of the cancellation if we cancel for any other reason. Item 9. of SECTION IV COMMERCIAL GENERAL LIABILITY CONDITIONS, is deleted and replaced with the following: 9. WHEN WE DO NOT RENEW a. If we choose to nonrenew this policy, we will mail or deliver to the first Named Insured shown in the Declarations written notice of the nonrenewal not less.than 60 days before the expiration date. b. If we do not give notice of our intent to nonrenew as prescribed in a. above, it is agreed that you may extend the period of this policy for a maximum additional sixty(60) days from its scheduled expiration date. Where not otherwise prohibited by law, the existing terms, conditions and rates will remain in effect during that extension period. It is further agreed that so long as it is not GL-3084 (01/06) -4-