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HomeMy WebLinkAboutECI SITE CONSTRUCTION MANAGEMENT INC - INSURANCE CERTIFICATEClient#: 41670
ECISI
ACORD CERTIFICATE OF LIABILITY INSURANCE
OATE(M
09/30/201YVV)
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: Sandy SChlffernS
Flood 8, Peterson Ins., Inc.
n/co No Ert:970-266-7107 ac No: 970-506-6845
P. O. Box 578
E-MAIL andy.schifferns@floodandpeterson.com
Greeley, CO 80632
PRODUCE
ECISI
970 356-0123
CUSTOMER ID,
INSURER(S) AFFORDING COVERAGE
NAIC0
INSURED
INSURER A: Travelers Insurance Company
ECI Site Construction Management, Inc.
INSURER B: National Union Fire Co of Pitts
PO Box 2135
INSURERC: Pinnacol Assurance
Loveland, CO 80539
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.
TYPE OF INSURANCE
POLICY NUMBER
M/DD/YYYY M
Y EXP
MWDD/VYYY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
X PD Ded:2,500
DTC08099A7531ND11
10/01/2011
10/01/2012
EACHOCCURRENCE
$1 OOOOOO
PREMISES Ea occurrence
s3000OO
MED EXP (Any one person)
$5,000
PERSONAL & ADV INJURY
$1 000 000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY F PRO LOC
PRODUCTS - COMP/OP AGO
$2,000,000
S
A
AUTOMOBILE
LIABILITY
MY AUTO
ALL OWNED AUTOS
SCHEDULEDAUTOS
HIREDAUTOS
NON -OWNED AUTOS
DT8108099A753TIL11
10/01/2011
10/01/2012
COMBINED SINGLE LIMIT
(Ea accident)
$
1 000.000
X
BODILY INJURY (Per person)
S
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
X
X
$
$
B
X
UMBRELLA LIAB
EXCESS DAB
OCCUR
CLAIMS -MADE
BE025036204
10/01/2011
10/01/2012
EACH OCCURRENCE
$5 000 000
AGGREGATE
$5 000 000
DEDUCTIBLE
RETENTION S 0
$
C
WORKERS COMPENSATION
ANDEMPLOYERS'LIABILITY Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes describe under
DESCRIPTION OF OPERATIONS below
N/A
1221742
7/01/2011
07/01/201
X WC$TATU- OTH-
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE EA EMPLOYEE
$1,000,000
E.L. DISEASE - POLICY LIMIT
$1 000 000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more space Is required)
Re: Contractor's License
City of Fort Collins
PO Box 580
Ft 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
#S651134/M651130
01988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
SLS