HomeMy WebLinkAbout111183 COULSON EXCAVATING CO INC - INSURANCE CERTIFICATE (3)ACORD.� CERTIFICATE OF LIABILITY INSURANCE 6/1512 00 '
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Willis of Colorado, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
720 South Colorado Boulevard HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Suite 60ON ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver, CO 80246 INSURERS AFFORDING COVERAGE NAIC #
INSURED
Coulson Excavating Co., Inc.
3609 North County Road #13
Loveland, CO 80538
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INSURER A
INSURER s: Great American Insurance Compan 16691
INSURER C:
INSURER D.
• • •� • w•�,�� ..� rw . ua. cu MCLOW NAVE BEEN ISSUED TO THE INSURED NAMED A30VE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REOUIRE.MENT, TERM OR CONDITION OF ANY CONTRACT OP. OTHER DOCUMENT WI' H RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL LHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
�T
TYPE OF INSURANCE
POLICY NUMBER
POL!CSYEFFECTIVE
IPOLAICYIEXPIRA`ION
05/01/11
I
LIMITS
A
GENERAL
X
L"ILITY
COMMERCIAL GENERAL LIABILITY
CLAUS MADE X I OCCUR
Ltd Pollution
GL03888949
051,01/10
EACH OCCURRENCE
$1 000 000
DAMAGE TO
E100000
MED EXP (Arty a oenwn)
$10 000
X
PERSONAL d ADV INJURY
$1 000 000
X
Al# LIGL`l175BCW W07
GENERAL AGGREGATE
s2.000.000
GEII•L AGGREGATE LIMr APPUES PER:
POLICY FT � Ix I LOr.
PRODUCTS - COMPrCP AGO
S2.000.000
A
AUTCMOBILELIA&UTY
X
ANY AUTO
BAP3838950
05/01/10
05104ill
COMBINED SINGLE OMIT
(Eaaccidentj
$1,000,000
ALL OWNED AUTOS
SCHEDULED AUKS
3CDILY INJURY
(Fer acsonl
S
/
X
X
HIRED AUTOS
NON -OWNED ALTOS
SCDILY!NJUP.Y
(Per acd(Wnt)
S
X
Ltd Pollution
PROPERTY DAMAGE
(Per accident)
E
LIABS.J:Y
AUTO ONLY - EA ACCIDENT
i
IGARAGE
ANY AUTO
(
I
BSSIUMBRELLAL�LTY
CWMSMADE
TUE033L70501
05101/10
05;01/11 �EACHOCCURREOCCUR
OTHER THAN E4 ACC
AUTO ONLY: AGO
S
s
AGGREGATE I$5,DOO.000
E
DEDUCTIBLE
.RETENTION S
s
A
WCRK_=Rscc6:PalLrrY NANn
ENPLDYERS' LIABILITY -
NJC3888359
G5/01/10 IOSi01i11
�X
f wcs."A' I oT._
S
E.L. EACH ACCIDENT
$1,000,000
ANYPROPRETORIP4RTNER1EXECUTNE
OFFICERNEMBEi OCCLUDED'
E.L. DISEASE -E4 EMPLOYEE
S1,000,000
If ras, describe wrdw
. �RGVISICNS bebw OTHER
OTHER
EL DISEASE -POLICY LIMIT
$1,000,000
DESCRIPTION OF OPERATIONS! LOCATIONS I VEHICLES; EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS
Project Description: On -Going Maintenance Work at the Fort Collins/Loveland Airport.
The following are Additional Insureds as respects General Liability only
if required by written contract and coverage applies only as respects
(See Attached Descriptions)
CERTIFICATE HOLDER CANCELLATION
The City of Loveland and The
City of Fort Collins
4900 Earhart Road
Loveland, CO 80538
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL -In* DAYS WITT REN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, eUT FAILURE TO DO BO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
ACORD 25 I2nol/nRl . _s a ------------
A :HORIZED REEPPRESENTATIVE _
�ilf
.r a 8MSTY o ACORD CORPORATION 1983