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HomeMy WebLinkAbout157655 WATTLE & DAUB CONTRACTORS INC - INSURANCE CERTIFICATE, 6._ R CERTIFICATE OF LIABILITY INSURANCE � DATE (MM DD011 12/21/2D11 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 endorsements . PRODUCER Denver Agency Company 210 University Blvd, Suite 600 Denver CO 80206-4661 CONTACT Laura Maes NAME: PHONE (3O3) 892-6900 FAX fAIC Net (303)992-6938 A E-MIL .laura@ denveragency. com INSURERS AFFORDING COVERAGE NAIC k INSURERAAtain Specialty Ins CO %Burns 6 Wilcox INSURED Wattle S Daub Contractors, Inc. 8 Gibbs Rd. Laramie WY 82070 INSURER B:Travelers Indemnity Company 5658 INSURERC:Pinnacol Assurance 41190 INSURER D: INSURER E : 1 INSURER F: COVERAGES CERTIFICATE NUMBER:2012 Carl Carts 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 ADDL SUBR POLICY NUMBER POLICY EFF IMMIDDNYYYI POLICYEXP IMMIDiLIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxIOCCUR IP112882 /1/2012 /1/2013 DAMAGE T RENTED PREMISES lEaoccurrence) $ 50,000 MED EXP(My one person $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO LOC $ LIABILITY COMBINED SINGLE LIMIT 1,000,00 BODILY INJURY (Per person) $ B ANY AUTO AU OS SCHEDULED AUTOS AUTOS -12BIY079-12-SEL 1/1/2012 1/1/2013 POMOBILE BODILY INJURY Per accident ( 1HIRED $ AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per ac enl $ Underinsured motorist $ 1 000 000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED I I RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITYFR ANY PROPRIETORIPARTNERlEXECUTIVE Y/N OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If DySCRIPcdbe antler DESCRIPTION un OPERATIONS below N/A 093011 /1/2012 /1/2013 X I WC STQBYUATU- OTH- E.L. EACH ACCIDENT $ 1,000,000 EL.DISEASE - EA EMPLOYEE $ 1 000 000 EL DISEASE -POLICY LIMIT $ 1 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space is required) Additional Insured regarding General Liability: City of Fort Collins and Poudre Landmark Foundation, Inc., 108 North Meldrum, Fort Collins, CO 80521. Project: Historic Fort Collins Water Works Stabilization, CHS/SHF Project #2008-01-025. City of Fort Collins P.O. Box 580 Fort Collins, CO 80524 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 25(2010/05) McKeever, CIC/LAURA © 1988-2010 INS025(201005).01 The ACORD name and logo are registered marks of ACORD All rinhte rasarvad