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HomeMy WebLinkAbout407669 C AND J TRENCHING - INSURANCE CERTIFICATE (2)t—H - 6-U. we-2cw rated -ad ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE 6/30/2009"YYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Ins. Inc. P. O. Box 578 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 4687 W. 18th Street Greeley, CO 80632 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: United Fire & Cas. C & J Trenching and Construction Inc INSURER B: Pinnacol Assurance 421 Bobcat Drive Milliken, CO 80543 INSURER C: INSURER D: INSURER E: rnVFRAGFS 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 LTR ADD* NSR TYPE OF INSURANCE POLICY NUMBER DATE (MMIDD TIVE POLICY EXPIRATION LIMITS A GENERAL LIABILITY 60080110 07/18/09 07/18/10 EACH OCCURRENCE $1 000 000 PREMISES (Ea occurrence) DAMAGE TO RENTED $100 000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE � OCCUR MED EXP (Any one person) $5 000 PERSONAL & ADV INJURY $1 000 000 X PC Ded:250 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 POLICY JE� LOC A AUTOMOBILE LIABILITY ANY AUTO 60080110 07/18/09 07/18/10 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS X SCHEDULED AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ B WORKERS COMPENSATION AND 4099105 01/01/09 01/01/10 X WCSTAIT DER EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $100 000 E.L. DISEASE - EA EMPLOYEE $100,000 OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $500 000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Re: Snow Removal - Attn: John Stevens City of Fort Collins, its officers, agents and employees are named as (See Attached Descriptions) IL" 3L1 U tIJ"_.. ii 01,•13i RauRa1W_l1 L•J. City of Fort Collins P O Box 580 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 -An 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 AUTHORIZED REPRESENTATIVE �JOooR � B4�JSOs�J .�ieJt✓ra►.�1tJ! a Tnit, AGURD 25 (2001/08) 1 of 3 #S456511/M456412 TLA © 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 #S456511/M456412 DESCRIPTIONS (Continued from Page 1) additional insured, but only as respectsliability arising out of ongoing operations of the named insured (Excluding Workers' Compensation). AMS 25.3 (2001/08) 3 of 3 #S456511/M456412