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Home My WebLink AboutCUTLER REPAVING - INSURANCE CERTIFICATE (3)ACORD CERTIFICATE OF LIABILITY INSURANCE OCUTLE 2 DA07 31 9) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Johnston Fiss Insurance 5225 West 75th Street, #200 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # Shawnee Mission KS 66208 Phone : 913-396-0800 Fax : 913-396-0835 INSURED INSURER A: Hartford Fire Insurance Co 29424 INSURER B: Hartford Underwriters Ins Co. Cutler Repaving -Attn • Bob Veskerna Company, Inc. INSURER C: Twin city Fire Insurance co INSURERD: Cincinnati Insurance Co. 10677 921 'E. 27th Lawrence KS Street 66046 - INSURER E: rnvroer_I=c 1 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. INSIR LTR NSR I 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 PREM ISE S (Ea occureunce) $300,000 B X COMMERCIAL GENERAL LIABILITY 37CQT1562 08/01/09 08/01/10 MED EXP (Any one person) $ 10 , 000 CLAIMS MADE X� OCCUR PERSONAL & ADV INJURY $1,000,000 X Blkt Add'1 Insd X Waiver of Subro GENERAL AGGREGATE $ 2 , 000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 - Emp Ben. 1,000,000 POLICY X PER& LOC A AUTOMOBILE LIABILITY ANY AUTO 37UENQT1563 08/01/09 08/01/10 COMBINED SINGLE LIMIT (Ea accident) $ 1 � � � � � 000 X. BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED _AUTOS X BODILY INJURY (Per accident) $ HIRED AUTOS NON-OWNED'AUTOS X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG D EXCESS/UMBRELLA LIABILITY X OCCUR F-1CLAIMSMADE CCC1152728 08/01/09 08/01/10 EACH OCCURRENCE $ 4,000,000 AGGREGATE $4,000,000 $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND TA X TORY LIMITS ER C EMPLOYERS' LIABILITY ANY PROP RI ETOR/PARTN E R/EXEC OFFICER/MEMBEREXCLUDED? UTIVE 37WEQT2118 08/01/09 08/01/10 E.L. EACH ACCIDENT $500000 E.L. DISEASE - EA EMPLOYEE $500000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $500000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS re: Hot -In -Place Recycling Project - Bid No. 6077 - 2009 Renewal The City of Fort Collins operations. Insurance is Additional Insured for on -going and completed is primary and Non -Contributory. Waiver of subrogation applies where permitted by law rFaTIFIrATF Hnl nFR I CANCELLATION FTCCO01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fort Collins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 40 DAYS WRITTEN Financial Services NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Purchasing Division IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 215 N. Mason St, 2nd Floor Fort Collins CO 80522 REPRESENTATIVES. ALI rHORtZED_-7RE59NTA11t�--*,,. ACORD 25 (2001/08) U ACORD cURPURAIIUN 1VU5 I0L'•: 1 aI 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. fi KU ZO �NUI/Uif)