HomeMy WebLinkAbout147906 SAUNDERS CONSTRUCTION INC - INSURANCE CERTIFICATE (5)SAUND-1 OP ID: DP
'4li.i CERTIFICATE OF LIABILITY INSURANCE
DAT09112DIYYYVI
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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(les) 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 endorsements .
PRODUCER 303-867-2066
NONEACT
Olson &Olson Ltd. 303-867-2074
GreenwoodS Yosemite Street #1018011
GreeVillage, CO 80111
(AJCPHONE 303-867-2055 KC No : 303-867-2074
lac H_. EMI:
A ..RIESs: o2@olsonandolson.com
Lance M Olson
INSURERS AFFORDING COVERAGE
NAIL A
INSURER A: Travelers P & C CO of America
25674
INSURED Saunders Construction, Inc.
INSURER B: Phoenix Insurance Company
25623
6950 S. Jordan Rd.
Centennial, CO 80112
INSURERC: Starr Indemnity & Liability Co
38318
INsuRERo: Pinnacol Assurance
INSURERE: Great American Insurance Co
16691
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
LTn
TYPE OF INSURANCE
ADDL
SUB
POLICY NUMBER
POUCYEFF
MMIDDIYYYY)
POLICYEXP
(MMIDDIYYYY
LIMITS
GENERAL W&CITY
EACCli OCTCURRENCE
$ 2,000,00
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
X
X
DTC0325D309APHX11
04130111
04/30/12
AGEB
PREMISES Ea occurrence
$ 300,00
MED EXP(AnYone person)
5 5,00
PERSONAL B ADV INJURY
$ 2,000,00
GENERAL AGGREGATE
S 4,000,00
GEN'L AGGREGATE
LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGO
S 4,000,00
POLICY
X PRO- LOC
S
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea acddenl
$ 1,000,00
BODILY INJURY Per person)
$
A
X ANY AUTO
X
DT810325D309ATIL11
04/30111
04/30112
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY IPer accident)
$
X HIRED AUTOS X NON -OWNED
AUTOS
PROPERTY DAMAGE
Peracciden[
S
$
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
S 10,000,00
X
AGGREGATE
$ 10,000,00
D
EXCESS Me
CLAIMS -MADE
SISCCCLO1421711
04/30/11
04/30/12
OE D X RETENTIONS 0
S
D
WORKERS COMPENSATION
AND EMPLOYERS' LIABLLm'
ANY PROPRIETORIPARTNERIEXECUTIVE YIN
OFFICERNEMBER EXCLUDED'
INin NH)
N I A
X
3096125
10/01/11
10101112
X T /RY LAM T OTH-
e.L. EACH ACCIDENT
$ 500,00
EL DISEASE-FAEMPLOYEE
S 500,00
If DESCRIPTION OF OPERATIONS below
E.L. DISEASE- POLICY LIMIT
S 500,00
E
Professional
PCE211129601
02128111
02128112
See Belo
an Pollution
DESCRIP OF OPERATIONS I LOCATIONS I VEHICLES IAttach ACORD 101, Additional Renurils Schedule, It more space Is required)
7033 Dis very Museum Facilittyy Bid. Professional Liability Claims -Made Form
. 2,000,000 each claim/(rD2,006,000 aggregate. City of Fort Collins is
included as Additional Insuredd� primary basis as respects General Liability
per form CGD246 08105 attached and as Additional Insured as respects Auto
Liability per form CAT353 03110 attached. Waiver of Subrogation
City of Fort Collins
Attn: Financial Services
Purchasing Division
P.O. Box 580
Fort Collins, CO 80522-0580
CITYFO2
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
(198R-2010 ACORn CORPORATION. All rinhtc
ACORD 25 (2010/05)
The ACORD name and logo are registered marks of ACORD
No Text
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-
erly damage" or 'personal injury" arising out
of the rendering of, or failure to render, any
professional architectural, engineering or sur-
veying services, including:
i. 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.
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 we 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 9 20D5 The St. Paul Travelers Companies, Inc. Page i 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 carefully 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 II — 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
I.
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 ness.
that person or organization, that is signed and
CA T3 53 03 10 ® 2010 The Travelers indemnity Company. Page 1 Of 4
Includes copyrighted material of Insurance services Office, Inc. with its permission.