HomeMy WebLinkAbout150588 WALSH CONSTRUCTION INC - INSURANCE CERTIFICATE (8)OP ID: SC ACORO° t_ CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDYYY) IY02/22/12 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 -- - 970-223-1804 FrontRange Insurance Group 1100 Haxton Drive Suite 100INC,a Fort Collins; CO 80525,. David A. Wooldridge LUTCFAAI - - --ADDRESS:PRODUCER v CONTACT - - - PHONE FAX. ". xt l - aC No E-MAIL -. T ME e: WALSH-4 - CUSTOMERID INSURERS AFFORDING COVERAGE NAIC k INSURED Walsh Construction, Inc. INSURER A: Pinnacol Assurance 41190 Matthew Walsh, Pres. INSURER B: Builders Insurance Group 8139 Open View Place INSURER C: Colorado CasualtyCo. Loveland, CO 80537 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. INSR LTR TYPE OFINSURANCE ADDIL Suds POLICY NUMBER MMIUD/YYYY MMIDDIYYYY LIMITS B GENERAL LABILITY X COMMERCIAL GENERAL LIABILITY ' CLAIMS -MADE FX] OCCUR - X GLP010429101 02/13/12 02/13/13 - EACH OCCURRENCE $ 1,000,00 AMA ET R T D PREMISES Ea oNTEO ce $ 100,00 MEDUP(Anyoneperson)- $ 5,00 PERSONAL B ACV INJURY $" 1,000,00 GENERAL AGGREGATE-- $ 2,000,00 GEN'L AGGREGATE _X1 POLICY LIMIT APPLIES PER JECT PRO LOC PRODUCTS - COMP/OP AGO $ 2,000,00 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Peraccident) $ $ 8 X UMBRELLA LIAB EXCESS UAB X OCCUR CLAIMS -MADE UM6011984900 02/13112 02113113 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY IN ANY PROPRIETORMARTNERIEXECUTIVEY❑ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS be low NIA 4104351 05/01111 05101112 WC STATU- X 0'H- E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEEI $ 1,000,00 E.L.DISEASE -POLICY LIMIT 1 $ 1,000,00 C Colorado Casualty IM8576376 01/26112 01126/13 Rented 50,00 Deduct 50 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more space Is required) City of Ft. Collins is listed as an Additional Insured with regards to the General Liability policy. CERTIFICATE HOLDER CANCELLATION CITYOFF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Purchasing ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 580 AUTHORIZED REPRESENTATIVE _ Fort Collins, CO 80522 ACORD 25 (2009109) © 1988.2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD OP ID: SC '4� R� CERTIFICATE OF LIABILITY INSURANCE DAT02122DIYYYV) oz/2zn z 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 - 970-223-1804 Front Range Insurance Group 1100 Haxton Drive Suite 100 Fort Collins, CO 80525 - _ David A. Wooldridge LUTCFAAI - CONTA- NAME CT` PHONE FAX AID, No Ext: INC, No: E-MAIL ADDRESS:PRODUCER CUSTOMER ID #: WALSH-4 INSURERS AFFORDING COVERAGE NAICM INSURED Walsh Construction, Inc. Matthew Walsh, Pres. 8139 Open View Place Loveland, CO 80537 INSURER A: Pinnacol Assurance 41190 INSURER B: Builders Insurance Group INSURERC: Colorado Casualty Co. INSURER D NSURER E: NSURERF: 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 LTR TYPE OF INSURANCE L IN&L B VIVO POLICY NUMBER EFF MMIDDIYYYY MPOLICY MIDDIYYY1' LIMITS B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY ,. CLAIMS; MADE OCCUR - X GLP010429101 02113112 02113113 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL SADVINJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GENLAGGREGATE LIMIT APPLIES PER X POLICY F7 PIFCT RO CDC PRODUCTS-COMPIOP AGG It 2,000,00 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON-OWNEDAUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ B X UMBRELLA LIAB EXCESS LIAB IX OCCUR CLAIMS -MADE UM6011984900 02113112 02113113 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE F— OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DE Ins,OF OPERATIONS below NIA 4104361 06/01/11 05101112 WC STATU- X OTH- EEL E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E. L. DISEASE -POLICY LIMIT $ 1,000,00 C Colorado Casualty IM8576375 01/26112 01126113 Rented 50,00 Deduct 50 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addltlonal Remarks Schedule, If more apace Is required) City of Fort Collins is listed as Additional Insured with respects to the General Liability policy for Snow Storm October 26, 2011 clean-up. City of Fort Collins Purchasing PO Box 580 Fort Collins, CO 80522 CITYOFF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORRED REPRESENTATIVE ACORD 25 (2009/09) v woo-cuva ml vrcu t vlcrvrva I Ruff. mu ngnm re5erve0. The ACORD name and logo are registered marks of ACORD OP ID: SC ,a►� Ro CERTIFICATE OF LIABILITY INSURANCE DAT02/22DIYYYY) 02/22/12 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 970-223-1804 FrontRangelnsurance Group 1100 Haxton Drive Suite 100 Fort Collins, CO 80525 - David A. Wooldridge, LUTCFAAI CONTACT - - - PHONE FA% INC. No Exit, - qlG No): E-MAIL ADORESS: PRODUCER CUST016 WALSH-4 - ID N: INSURERS AFFORDING COVERAGE NAIC R INSURED Walsh Construction, Inc. INSURER A: Pinnacol Assurance 41190 Matthew Walsh, Pres. INSURER B:Builders Insurance Group 8139 Open View Place INSURER C: Colorado Casualty Co. Loveland, CO 80537 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. INSR LTR I TYPE OF INSURANCE A POLICY NUMBER MM DD/YYYY MMIDDIYYYY LIMITS B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY 17 CLAIMS -MADE OCCUR _ + X GLP010429101 - 02/13112 - 02113113 EACH OCCURRENCE - $ 1,000,00 DAMA R NTED PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL B ADV INJURY $ - 1,000,00 GENERAL AGGREGATE - $ 2,000,00 GENT AGGREGATE LIMIT APPLIES PER. X POLICY PRO LOC"CT PRODUCTS - COMP/OP AGG $ 2,000,00 $ AUTOMOBILE LIABILITY ANY AUTO - ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODI LY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ B X UMBRELLA LUIS EXCESS LIAB X OCCUR CLAIMS -MADE UM8011984900 02/13112 02113113 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YI❑N ANY PROPRIETOR/PARTNER/EXECUTIVE IM OFFICEREMBER EXCLUDED' (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 4104361 05/01111 05101112 WC STATU- X OTH- E.L EACH ACCIDENT $ 1,000,00 E.L. D11E ASE -EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,00 C Colorado Casualty IM8576375 01/26112 01126/13 Rented - 50,00 Deduct 50 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace Is required) - Project: Fossil Creek Trail at Stanton Creek Bid ll7289 City of Fort Collins is listed as Additional Insured with respect to the General Liability. policy. CITYOFF City of Fort Collins Purchasing 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 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD