HomeMy WebLinkAbout184254 DURAN EXCAVATING INC - INSURANCE CERTIFICATEClient#: 28315
DUREX
ACORD,. CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DDIYYYY)
12/15/2010
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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).
PRODUCER
Flood & Peterson Ins., Inc.
Corporate Mailing Address:
P. O. Box 578
CONTACT
NAME:
PHONE 970 356-0123 FAX 970 506-6836
A/C No Ext : A/C, No :
ADDRESS: debra.morris@fpinsurance.com
Greeley, CO 80632
CUSTOMER ID #:
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURED
INSURER A: Travelers Insurance Company
Duran Excavating Inc
418 N 9th Ave
INSURER B Pinnacol Assurance
Greeley, CO 80631-2350
INSURER C :
INSURER D :
INSURER E
INSURER F :
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFF
MMIDD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
A
GENERAL LIABILITY
DTC08077BO49IND10
04/09/2010
04/09/2011
EACH OCCURRENCE
$1 000 000
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE FRI OCCUR
DAMAGE TO RENTEDPREMISES Ea occurrence
s300,000
MED EXP (Any one person)
$10,000 -
X PD Ded:2,500
PERSONAL & ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$2,000,000
r-
17 POLICY nPRO-JFCT LOC
-
$
A
(AUTOMOBILE
LIABILITY
ANY AUTO - �•'
DT8108077BO49TIL10
04/09/2010
04/09/2011
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
�.,_ 1.?`>•. �•.,
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
NON -OWNED AUTOS
X
$
A
X
UMBRELLA LIAB
OCCUR
DTSMCUP8077BO49TIL
04/09/2010
04/09/2011
EACH OCCURRENCE
s4,000,000
AGGREGATE
s4,000,000
EXCESS LIAB
CLAIMS -MADE
DEDUCTIBLE
$
X
$
RETENTION $ 10000
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNERIEXECUTIVE
OFFICER/MEMBER EXCLUDED? ❑
NIA
4110254
01/01/2011
01/01/2012
X WCSTATU- OTH-
E.L. EACH ACCIDENT
$1 OOO,OOO
E.L. DISEASE - EA EMPLOYEE
$1,000,000
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$1 000,000
A
Equipment'
QT6601423C736TIL10
04/09/2010
04/09/2011
Blanket Limit
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
Project: Construction of the 7048 Mason Bike/Pedestrian Trail - Spring Creek to Prospect Road
City of Fort Collins and CDOT are named as Additional Insured.
City of Fort Collins
Purchasing Division
215 N. Mason Street 2nd Floor
P. O. Box 580
Fort Collins, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
01988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
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