HomeMy WebLinkAboutCUTTING EDGE EXCAVATING - INSURANCE CERTIFICATEOP ID D DATE (MMIDD/YYYY)
ACORD CERTIFICATE OF LIABILITY INSURANCE CUTTI-1 06 18 09
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Brown & Brown Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
125 S Howes, 5th Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P O Box 2226 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins CO 80522-2226 -
'Phone:970-482-7747 -Fax:'970-484-4165
Cuttingg
Edge Excavation
749 S Lemay A3 PMB 402
Fort Collins C6 80524
rnVFRAnPR
INSURERS AFFORDING COVERAGE NAIC #
INSURERA: Mountain States Mutual 14648
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. 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 JCDD
LTR 1NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM/DD/YY
POLICY EXPIRATION
DATE MMIDD/YY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1000000
A
X COMMERCIAL GENERAL LIABILITY
CPP011783302
05/28/09
05/28/10
DAtuIA
PREMISES(Eaoccurenc.)
$ 100000
CLAIMS MADE X� OCCUR
MED EXP (Any one person)
$ 10000
PERSONAL & ADV INJURY
$ 1000000
X Blkt Addl Insd
X
Blkt WOS
GENERAL AGGREGATE
$ 2000000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OPAGG
s2000000
POLICY n PRO- El LOC
JECT
A
AUTOMOBILE
LIABILITY
ANY AUTO
BAP011783302
05/28/09
05/28/10
COMBINED SINGLE LIMIT
(Ea accident)
$
X
BODILY INJURY
(Per person)
$ 1000000
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$ 1000000
A
X OCCUR CLAIMSMADE
UMB011783302
05/28/09
05/28/10
AGGREGATE
$ 1000000
$
$ '
0DEDUCTIBLE
$
X RETENTION $ 10000
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
_
-
TORY LIMITS IUIH
ER
E.L. EACH ACCIDENT
—
$
E.L. DISEASE - EA EMPLOYE
$
OFFICER/MEMBER EXCLUDED?
If Yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$
OTHER
A
Equipment Floater
CPP011783302
05/28/09
05/28/10
Lsd/Rentd $100,000
Ded $1,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Excavation - City of Fort Collins is included as Additional Insured with
respects to General Liability.
CERTIFICATE HOLDER CANCELLATION
FTCPURC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
City of Fort Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Purchasing Department IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
215 N Mason
Fort Collins CO 80522 REPRESENTATIVES.
f{tffNQ[tIZED REPRESE
ACORD 25 (2001/081 ACORD CORPORATION 198E