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Home My WebLink About380591 J 2 CONTRACTORS - INSURANCE CERTIFICATE (11)A� RL® CERTIFICATE OF LIABILITY INSURANCE ioisi�o11Y) 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, ANDTHECERTIFICATE 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 thisCertificatedoes not confer rights to the certificate holder in lieu of such endorsement(s). - - - PRODUCER - Moody Insurance Agency, .Inc. _ 8055 East Tufts Avenue Suite 1600 Denver CO 80237 CONTACT NAME: AOt UIIIn Lee, CISR'- - - - (803)629-.6600 Fes' (303)3]0-011$ PHONE AC No) E-MAILDRE.aleeWaloodyins. com -- INSURERS AFFORDING COVERAGE 'NAIC# INSURERA:Plnnacol Assurance 41190 INSURED J-2 Contracting Co., Inc. PO BOX 129 Greeley CO 80632 INSURER B: INSURER C: INSURER D: INSURER E : INSURER F: COVERAGES I 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 LTR TYPE OF INSURANCE ADDLSUBR POLICY NUMBER POLICY EFF MM DNYYY) POLICY EXP fMM/DDfYYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Me occurrence $ MED EXP (Any one person) $ CLAIMS -MADE ❑ OCCUR PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AUG $ - POLICY 'PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Fif accident)- - BODILY INJURY (Per person) $ - .. ANY AUTO -. .. _ ALL OWNED SCHEDULED AUTOS AUTOS, „ BODILY INJURY Per accident ( ) $ PROPERTY DAMAGE Per pent $ NON -OWNED: HIRED AUTOS AUTOS A � � $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) N/A -__ _ -_,- 114522 0/1/2011 0/1/2012 R WC STATU- I R OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L DISEASE -POLICY LIMIT $ 11000,000 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (ANach ACORD 101, Additional Remarks Schedule, 0 more specs is required) Blanket WOS City of Fort Collins 215 North Mason Street 2nd Floor 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 (2010105) Lee, CISR/AUTLEE 01988-2010 ACORD CORPORATION. All rights reserved. INSo25 (20100$).01 The ACORD name and logo are registered marks of ACORD