HomeMy WebLinkAboutSCHMIDT EARTH BUILDERS - INSURANCE CERTIFICATEACORD. CERTIFICATE OF LIABILITY INSURANCE M/D
2 18/18/200909
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Van Gilder Insurance Corp. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
700 Broadway, Suite 1000 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Denver CO 80203 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
INSURED INSURERA: Zurich American Insurance Comip
Schmidt Earth Builders, Inc. INSURER B: National Union Fire Ins. Co.
7250 Greenridge Road
Windsor CO 80550 NSURERC:
INSURER D:
INSURER E:
nnVFRAnFR
HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
OTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
ERTIFICATE 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 LTRTYPE
OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRADATE,MMIDDITION
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE KI OCCUR
GLO375719404
3/l/2009
3/1/2010
EACH OCCURRENCE
$1000000
FIRE DAMAGE (Any one fire)
$10 0 0 0 0
MED EXP (Any one person)
$10 0 0 0
PERSONAL & ADV INJURY
$1000000
GENERAL AGGREGATE
$2000000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY X PRO- X LOC
PRODUCTS - COMP/OP AGG
$2 0 0 0 0 0 0
•
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
BAP375719304
3/1/2009
3/1/2010
COMBINED SINGLE LIMIT
(Ea accident)
$1000000
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
B
EXCESS LIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
BE022672806
3/l/2009
3/1/2010
EACH OCCURRENCE
$4000000
AGGREGATE
$ 4 0 0 0 0 0 0
$
$
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
WC375719204
3/l/2009
3/1/2010
X I Two RYTAwl, T OER
E.L. EACH ACCIDENT
$1000000
E.L. DISEASE - EA EMPLOYEE
$1000000
E.L. DISEASE - POLICY LIMIT
$1000000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Additional Insured (excluding workers compensation) and Waiver of Subrogation applies as required by written contract.
11 coverage terms, conditions, exclusions and limitations of policy apply.
"ULUCK I I ADDITIONAL INSURED: INSURER LETTER:
City of Fort Collins
256 W. Mountain
Fort Collins CO 80521
k,ANI;tLL.A I IUN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
3EFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER
VILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE
:ERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO
>HALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON
CHE INSURER, ITS AGENTS OR REPRESENTATIVES.*EXCEPT 10 DAYS
40TICE FOR NON-PAYMENT OF PREMIUM.
AUTHORIZED REPRESENTATIO. " ■ IL it
6
ACORD 25-S (7/97) 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.
AWKU Lb-J (11W)