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HomeMy WebLinkAboutDIAMOND EXCAVATING INC - INSURANCE CERTIFICATE (17)Client#: 51923 8DIAMEXC ACORDn., CERTIFICATE OF LIABILITY INSURANCE DATE(MMIOD/YNYN) F 3/29/2012 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: Willis of Colorado, Inc. PHONE 303 722-7776 FAX, 303-722-8862 A/C No Est : AIC, No 720 South Colorado Boulevard E-MAIL Suite60ON ADDRESS: INSURER(S) AFFORDING COVERAGE NAIL# Denver, CO 80246 y Bituminous Casualty Corp.0095 INSURER A: P� INSURED INSURER B : Plnnacol Assurance 41190 Diamond Excavating, Inc. ' 5940 W.59th Avenue INSURER C: Arvada, CO 80003 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 CONTRACTOR 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 ADD L INSR SUB MD POLICY NUMBER POLICY EFF (MMIDD/YYYY) POLICY E%P (MMIDDIYYYY LIMITS A GENERAL LIABILITY CLP3560934 10/16/2011 10/1612012 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 5� OCCUR PREMISES EeENTo cued $1 OO OOO MED EXP (Any one person) $ 5 000 PERSONAL BADVINJURY $1,000,000 X AI# GL-4665 01/11 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGO s2,000,000 POLICY X PRO ECT X LOG $ A AUTOMOBILE LIABILITY CAP3560936 10/1612011 10/16/201 CO BINEDt SINGLE LIMIT (EaIX $1,000,000 BODILY INJURY (Per person) $ ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per actltlent) E PROPERTY DAMAGE$ Per accident HIRED AUTOS X NON -OWNED AUTOS E A X UMBRELLA LIAB X OCCUR CUP2591080 10/1612011 10/16/2012 EACH OCCURRENCE 11510001000 AGGREGATE s51000.000 EXCESS LIAB CLAIMS -MADE DED I X RETENTION $1 O 000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? � NIA 2296yw 4/01/2012 04/01/201 X we sTATu- DTH- RY LIMIT E.L. EACH ACCIDENT $1 000,000 E.L. DISEASE- EA EMPLOYEE E1 OOO OQO (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHI (Attach ACORD 101, A lonal Remarks Schedule, it more space is required) Project Description: Right of W Contractor License The following are Additional Insureds as respects General Liability only if required by written contract and coverage applies only as respects ongoing operations performed by the Insured for the (See Attached Descriptions) City of Fort Collins P. O. 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 (2010/05) 1 of 2 #S911475/M909979 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 8RSM1 . ........ . ... . . .... - q . .......... 1. ONS (Conti huedfrorft Page '; . Additional Insureds. Additional Insureds: City of Fort Collins All coverage terms, conditions and exclusions of the policy apply. The Additional Insured endorsement which is referenced above under "Type of Insurance -General Liability" is attached. M� . . . . . . . . . . a U-1 5 i ._t=! - ,- .q � � i- � , . - r.0 51. = � �, I : "mn M - � I . ...... .. .... OMUJ I I M 13.J VU I UIUO) A OTL #S911475/M909979 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Section II — Who Is An Insured is amended to include as an additional insured any person or organization who is required by written contract to be an additional insured on your policy for completed operations, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by 'your work" at the project designated in the contract, performed for that additional insured and included in the "products -completed operations hazard". This insurance is excess of all other insurance available to the additional insured, whether primary, excess, contingent or on any other basis, unless the written contract requires this insurance to be primary. In that event, this insurance will be primary relative to insurance policy(s) which designate the additional insured as a Named Insured in the Declarations and we will not require contribution from such insurance if the written contract also requires that this insurance be non-contributory. But with respect to all other insurance under which the additional insured qualifies as an insured or additional insured, this insurance will be excess. GL-4665 (01/11) Includes Copyrighted Material of Insurance Services Office With Its Permission