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HomeMy WebLinkAbout150588 WALSH CONSTRUCTION INC - INSURANCE CERTIFICATE (10)OP ID: SC A�ORO° CERTIFICATE OF LIABILITY INSURANCE DATE06/06DIYYYY) 1 s)osn 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 CONTACT PHONE FAX ac No Ext: ac No: E-MAIL ADDRESS: PRODUCER WALSH-0 CUSTOMER ID 0: INSURERS AFFORDING COVERAGE NAIC k INSURED Walsh Construction, Inc. Matthew Walsh, Pres. 8139 Open View Place Loveland, CO 80537 INSURER A;Pinnacol Assurance 41190 INSURER a: Builders Insurance Group INSURER C 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 OF INSURANCE ADOL B POLICY NUMBER POLICY EFF MMIDONYYY POLICY EXP MMIODNYYY LIMITS B GENERAL LIABILITY. X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX7 OCCUR X PKGO10429102 06/01/12 06/01/13 EACH OCCURRENCE $ 1,000,00 _I57JA=O RENTED PREMISES Ea domrrencon $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL B ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRO LOC X POLICY JPCT PRODUCTS - COMP/OP AGO $ 2,000,00 $ AUTOMOBILE LIASIDTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per parson) $ BODILY INJURY (Per accident) $ PROPERTYDAMAGE (Peramident) $ $ $ B X UMBRELLA LIAR EXCESS UAB X OCCUR CLAIMS -MADE UM8011984901 06101112 06101113 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ A WORKERS COMPENSATION ANU EMPLOYERS' LIABILITY ANY PROPRIETORFARTNER/EXECUTIVE YIN OFFICERIMEMBER E%CLUDED? (Mandatory In NH) yes. under DESCRIPTION under DESCRIPmritheTION OPERATIONS below N I A 4104361 05/01/12 05101113 WC STATU- I X OTH- 1 E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE t,000,00 $If E.L. DISEASE -POLICY LIMIT $ 1,000,00 B Inlantl Marine PKGO10429102 06/01/12 06/01/13 Sch Equip 220,20 Leas/Rent 50,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remerka Schedule, If more space Ia nqulred) City of Fort Collins is listed as Additional Insured with respects to the General Liability policy for Snow Storm October 26, 2011 clean-up. CERTIFICATE HOLDER CANCELLATION CITYOFF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CI Of Fort Collins City THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Purchasing PO BOX 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 ACORD 25 (2009/09) © 1988.2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD