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HomeMy WebLinkAboutMOUNTAIN CONSTRUCTORS - INSURANCE CERTIFICATE (3)AC"R" CERTIFICATE OF LIABILITY INSURANCE DA;24;2009) 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 Mountain Constructors, Inc. INSURER B: Pinnacol Assurance 41190 622 Main Street INSURER C: PO Box 405 INSURER D: Platteville CO 80651 INSURER E: CCIVFRAC;FS 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 OFSUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDT POLICY EFFECTIVE POLICY EXPIRATION L POLICY NUMBER D M DD YYY DOTE M D YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 X DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ 100,000 A X CLAIMS MADE X OCCURCLP3265961 7/28/2009 7/28/2010 MED EXP (Any one person) $ 5,000 Add' 1 Insured per PERSONAL & ADV INJURY $ 1,000,000 attached Form GL 3088 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: (01 06) PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $ 1,000,000 A ALL OWNED AUTOS CAP3531807 7/28/2009 7/28/2010 BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY NON -OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG S EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 1,000,000 X OCCUR CLAIMS MADE AGGREGATE $ 1,000,000 A DEDUCTIBLE CUP2585946 7/28/2009 7/28/2010 $ X RETENTION S 10,000 $ B WORKERS COMPENSATION X WC OT AND EMPLOYERS' LIABILITY Y / NER LIMITS ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) 3027994 7/1/2009 7/1/2010 E.L. DISEASE - EA EMPLOYEE$ 11000,000 It yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 11000,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Re: 6100 US 287/South College Avenue Bike Lanes City of Fort Collins is named as Additional Insured as respects General Liability. 10 Day Notice of Cancellation Applies to Non -Payment of Premium This certificate is subject to the terms, conditions, and exclusions of the policies. City of Fort Collins 215 North Mason Street Fort Collins, CO 80524 CANCELLATION SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BECANCELLED 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 Navarra, ACSR/CHANA ACORD 25 (2009/01) © 1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200901) The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LAND IMPROVEMENT CONTRACTORS EXTENDED LIABILITY COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM It is agreed that the provisions listed below apply only upon the entry QX in the box next to the caption of of such provision. A. X� Partnership and Joint Venture Extension J. 0 Broadened Conditions B. OX Contractors Automatic Additional Insured Coverage C. [X Automatic Waiver of Subrogation D. F-fl Extended Notice of Cancellation, Nonrenewal E. I Unintentional Failure to Disclose Hazards F. 0 Broadened Mobile Equipment G. IX Personal Injury - Contractual Coverage H. IX Nonemployment Discrimination I. IX Liquor Liability A. PARTNERSHIP AND JOINT VENTURE EXTENSION K. 0 Automatic Additional Insureds - Equipment Leases L. F XX Insured Contract Extension - Railroad Property and Construction Contracts M. Q Construction Project General Aggregate Limits N. F-X] Fellow Employee Coverage O. X� Property Damage to the Named Insured's Work P. 71 Care, Custody or Control The following provision is added to SECTION II - WHO IS AN INSURED: The last full paragraph which reads as follows: No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a Named Insured in the Declarations. is deleted and replaced with the following: With respect to the conduct of any past or present joint venture or partnership not shown as a Named Insured in the Declarations and of which you are or were a partner or member, you, and others identified in items 1.a., 1.b., and 1.c., subject to the conditions and limitations contained therein, are insureds, but only with respect to liability arising out of `your work" on behalf of any partnership or joint venture not shown as a Named Insured in the Declarations, provided no other similar liability insurance is available to you for "your work" in connection with your interest in such partnership or joint venture. r' 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. GL-3088 (01106) -1- mwMhull damage that results from any of the following work while being done by or for such landlord, lessor, manager, or owner: • Structural changes. • New construction work. • Demolition work. But we won't apply this Landlords section to your real estate managers. Instead, we'll apply the Real estate managers section, or the Employees and volunteer workers section, whichever section is applicable, to them. Equipment lessors. Any lessor or owner of equipment rented or leased to you is a protected person only for your operation, maintenance, or use of that equipment while you rent or lease it. However, no equipment lessor or owner is a protected person for injury or damage that results from its sole negligence. Persons or organizations for your work as required by written contract. Any person or organization that: • is not otherwise a protected person under this agreement; and • you specifically agree in a written contract to add as an additional protected person under this agreement; is a protected person, but only for covered bodily injury or property damage that results from your work. However, no such person or organization is a protected person for bodily injury or property damage that results from their sole negligence. Also, such person or organization is a protected person only for the lesser of: • the limits of coverage required by the written contract; or • the limits of coverage available under this agreement. Additional protected person may also be called an additional insured in that written contract. We explain the term your work in the Products and completed work total limit section. Vendors of your products. Any vendor of your products is a protected person for covered bodily injury or property damage that results from your products, but only if: • you specifically agree in a written contract to add the vendor as an additional protected person under this agreement; • this agreement provides coverage for those products; and • those products are sold or distributed in the normal course of the vendor's business. However, no vendor from whom you've acquired your products is a protected person. Nor is any vendor a protected person for bodily injury or property damage that results from: • any express warranty which is made by the vendor and you haven't authorized; • any change made in the condition of any of your products by the vendor; • the repackaging of your products other than when the products are unpacked for demonstration, inspection, testing, or replacement of parts ordered by you or the manufacturer, and later repackaged in their original containers; • any failure of the vendor to perform normal or agreed upon servicing of your products which the vendor has sold or distributed; • the demonstration, installation, or servicing of your products, which is done away from the vendor's premises; or • your products which have been labeled or relabeled, or used as an ingredient, part, or container in, on, or for anything else, by or for the vendor. Servicing includes any adjustment, assembly, disposal, inspection, repair or test. We explain the term your products in the Products and completed work total limit section. Operators of registered mobile equipment. All operators of registered mobile equipment are protected persons for covered bodily injury or property damage that results from their driving of such equipment on a public street or road with your permission. d 1-02 Printed in U.S.A. Insuring Agreement Page 9 of 28 VP033 E d Marine Insurance Co. `2002 All Rights Reserved ,Paul Fire an 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. "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. GL-3088 (01 /06) -3-