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HomeMy WebLinkAbout147906 SAUNDERS CONSTRUCTION INC - INSURANCE CERTIFICATE (2)CERTIFICATE OF LIABILITY INSURANCE OP D DATE (MM/DD/YYYY) 1 09/23/10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Olson & Olson Ltd. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 10800 E Geddes Ave Suite 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Englewood CO 80112 Phone:303-867-2055 Fax:303-867-2074 INSURED Saunders Construction, Inc. 6950 S. Jordan Rd. Centennial CO 80112 COVERAGES INSURERS AFFORDING COVERAGE INSURER A: Travelers Prop Cas Co of Amer INSURER B: Phoenix Insurance Compa INSURERC: Pinnacol Assurance INSURERD: Everest National Ins Co INSURER E: Great American Insurance Co NAIC # 25674 25623 10120 16691 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. INS LTR AUU' NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YYYY POLICY EXPIRATION DATE MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2 , OOO , O00 B X X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR DTC0325D309APHX10 04/30/10 04/30/11 PREMISES(Eaoccurence) s300,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $2,000'000 GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 4,000,000 POLICY x PRO ECLOC JT A X AUTOMOBILE LIABILITY ANY AUTO DT810325D309ATIL10 04/30/10 04/30/11 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 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 ACC AUTO ONLY: AGG $ ANY AUTO *EXCEPT 10 DAYS FOREA NON-PAYMENT OF PREMIUM $ EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ 10,000,000 D X I OCCUR F-1 CLAIMS MADE 7105000034101 04/30/10 04/30/11 AGGREGATE $10,000,000 $ RDEDUCTIBLE $ X RETENTION $ 0 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITYER ANY PROPRIETOR/PARTNER/EXECUTIV YI1 OFFICER/MEA/BER EXCLUDED-,N (Mandatory in NH) 3096125 1.0/01/10 10/01/11 X TORY LIMTS 7F I E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE $ 5 0 0 , 0 0 0 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 500 , 000 OTHER E Professional PCE211129600 02/28/10 02/28/11 See below and/or Pollution DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS 7033 Discovery Museum Facility Bid. Professional Liability Claims -Made Form Limits: $2,000,000 each claim/@2,000,000 aggregate. City of Fort Collins is included as Additional Insured - primary basis as respects General Liability per form CGD246 08/05 attached and as Additional Insured as respects Auto Liability per form CAT 353 06/09 attached. Waiver of Subrogation CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITYFO2 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 * DAYS WRITTEN City of Fort Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Attn : Financial Services IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Purchasing Division REPRESENTATIVES. P.O. Box 580 AUTHORIZED REPRESENTATIVE Fort Collins CO 80522-0580 ACORD 25 (2009/01) The ACORD name and logo are registered marks of ACORD riahts reserved 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 This Certificate of Insurance 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 (2009/01) in favor of City of Fort Collins included as respects General Liability, Auto Liability, and Workers' Compensation. COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED .(CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED— (Section II) is amended to include any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Cover- age Part; but: a) Only with respect to liability for "bodily injury", "property damage" or "personal injury"; and b) If, and only to the extent that, the injury or damage is caused by acts or omissions of you or your subcontractor in the performance of "your work" to which the "written contract requiring insurance" applies. The person or organization does not qualify as an additional insured with respect to the independent acts or omissions of such person or organization. 2. The insurance provided to the additional insured by this endorsement is limited as follows: a) In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance", the in- surance provided to the additional insured shall be limited to the limits of liability re- quired by that "written contract requiring in- surance". This endorsement shall not in- crease the limits of insurance described in Section III — Limits Of Insurance. b) The insurance provided to the additional in- sured does not apply to "bodily injury", "prop- erty damage" or "personal injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or sur- veying services, including: The preparing, approving, or failing to prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or- ders or change orders, or the preparing, approving, or failing to prepare or ap- prove, drawings and specifications; and ii. Supervisory, inspection, architectural or engineering activities. c) The insurance provided to the additional in- sured does not apply. to "bodily injury" or "property damage" caused by "your work" and included in the "products -completed op- erations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that oc- curs before the end of the period of time for which the "written contract requiring insur- ance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 3. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible "other insurance", whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover under this endorsement. However, if the "written contract requiring insurance" specifically requires that this insurance apply on a primary basis or a primary and non-contributory basis, this insurance is primary to 'other insurance" available to the additional insured which covers that person or organization as a named insured for such loss, and ire will not share with that "other insurance". But the insurance provided to the additional insured by this endorsement still is excess over any valid and collectible 'other in- surance", whether primary, excess, contingent or on any other basis, that is available to the addi- tional insured when that person or organization is an additional insured under such 'other insur- ance". 4. As a condition of coverage provided to the additional insured by this endorsement: a) The additional insured must give us written notice as soon as practicable of an 'occur- rence" or an offense which may result in a claim. To the extent possible, such notice should include: CG D2 46 08 05 © 2005 The St. Paul Travelers Companies, Inc. )11850 Page 1 of 2 COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement: The following listing is : -a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefuiiy to determine rights, duties, and what is,and' is not -covered. A. BROAD FORM NAMED INSURED B. BLANKET ADDITIONAL INSURED C. EMPLOYEE HIRED AUTO D. EMPLOYEES AS INSURED E. SUPPLEMENTARY PAYMENTS — INCREASED LIMITS F. HIRED AUTO — LIMITED WORLDWIDE COVERAGE — INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE — GLASS PROVISIONS A. BROAD FORM NAMED INSURED The following is added to Paragraph A.1., Who Is An Insured, of SECTION If — LIABILITY COV- ERAGE: Any organization you newly acquire or form dur- ing the policy period over which you maintain 50% or more ownership interest and that is not separately insured for Business Auto Coverage. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- ganization or the end of the policy period, which- ever is earlier. B. BLANKET ADDITIONAL,INSURED H. HIRED AUTO PHYSICAL DAMAGE — LOSS OF USE — INCREASED LIMIT I. PHYSICAL DAMAGE — TRANSPORTATION EXPENSES — INCREASED LIMIT J. PERSONAL EFFECTS K. AIRBAGS L. NOTICE AND KNOWLEDGE OF ACCIDENT OR LOSS M. BLANKET WAIVER OF SUBROGATION N. UNINTENTIONAL ERRORS OR OMISSIONS executed by you before the "bodily injury" or "property damage" occurs and that is in effect during the policy period, to be named as an addi- tional insured is an "insured" for Liability Cover- age, but only for damages to which this insurance applies and only to the extent that person or or- ganization qualifies as an "insured" under the Who Is An Insured provision contained in Section 11. C. EMPLOYEE HIRED AUTO 1. The following is added to Paragraph A.1., Who Is An Insured, of SECTION II — LI- ABILITY COVERAGE: The following is added to Paragraph c. in A.1., An "employee" of yours is an "insured" while Who Is An Insured, of SECTION II — LIABILITY operating an "auto" hired or rented under a COVERAGE: contract or agreement in that "employee's" name, with your permission, while performing Any person or organization who is required under duties related to the conduct of your busi- a written contract or agreement between you and dude that person or organization, that is signed and CA T3 53 06 09 © 2009 The Travelers Companies, Inc. Page 1 of 4 Includes the copyrighted material of Insurance Services Office, Inc. with its permission.