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Home My WebLink About109014 R. C. HEATH CONSTRUCTION CO - INSURANCE CERTIFICATEClient#: 25306 HEAC04 t d, 1: ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 9/27/2011 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 CONTACT NAME: Cindy Zimmerman Flood & Peterson PHONE 970-266-7155 970-506-6845 A/C No EN: MC, No: P. O. Box 578 ADDRESS: Cindy.zimmerman@floodandpeterson.com Greeley, CO 80632 PRODUCER 970 356-0123 CUSTOMER ID#: p a j INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Travelers Insurance Company R. C. Heath Construction Co. INSURER a: National Union Fire Insurance dba Heath Construction INSURER C, Pinnacol Assurance PO Drawer H Fort Collins, CO 80522 ID: NSURER INSUREfl 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. LUL TYPE OF INSURANCE POLICY NUMBER MWDD/YYY M&VDD/YVY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CIAIMS-MADE 51OCCUR X PD Ded: 5,000 DTCO298N6651 9/30/2011 09/30/2012 EACH OCCURRENCE $1 OOO OOO DAMA TO HEWED PREMISES E. occurrence $300OOO MED EXP (Any one person) $5,000 PERSONAL& ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: RO LOC POLICY X PWCT PRODUCTS - COMP/OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS DT810298N6651 9/30/2011 09/30/2012 COMBINED SINGLE LIMIT (Ed accident) $1000DDD X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X S B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS MADE BE020690765 9/30/2011 09/30/201 EACH OCCURRENCE $6 000 000 AGGREGATE $6 DDD 000 DEDUCTIBLE RETENTION S 10,000 $ X $ C WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN ANY PROPRIETOWPARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 4033691 10/01/2011 10/01/2012 XoTH- E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1000000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Anach ACORD 101, Additional Remarks Schedule, H more apace is required) RE: 6105 SE Branch Library Tenant Finish Certificate holder is named as additional insured (Excluding workers compensation). City of Ft Collins PO 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 ACORD 25 (2009/09) 1 Of 1 #S649271/M648717 1919BB-2U09 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CAZ