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HomeMy WebLinkAbout463826 TATONKA CONTRACTORS LTD - INSURANCE CERTIFICATEA�� �® CERTIFICATE OF LIABILITY INSURANCE 10/2/2017 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 Keller -Lowry Insurance Inc 1777 S Harrison St k700 Denver 0 80210 CONTACT Teresa Heupel DNE (303)756-9909 FAX PNfAlcN (303)756-8818 E"MAILRIESS .icanhelp@kellerlowry.com INSURERS AFFORDING COVERAGE NAIL# INSURER A:Cincinnati Insurance 10677 1 1 y a R "L rac\torso, LTD. Road EHUdSonCO 80642 INSURER B: INSURER CRun INSURERDINSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:12-13 GL REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED 1"0 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 MM DDIY1'YY POLICY EXP MMIDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE PREMISES OERENcurrDence $ 100,000 A CLAIMS MADE Fx1 OCCUR P5190742 0/20/2012 0/20/2013 MED EXP (Any one person) $ 10,000 PERSONAL B ADV INJURY $ 1,000,000 X BLKT ADDITIONAL INSURED GENERAL AGGREGATE 4 $ 2,000,000 x GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 }{ POLICY PRO LOG $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident) $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ WORKERS COMPENSATION WC STATU OTH- TnRY UM AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? ❑ N / A E.L. DISEASE - EA EMPLOYEq s (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space Is mainland) Certificate Holder, its officers, agents and employees is Additional Insured for General Liability per written contract with Insured subject to terms and conditions of the policy contract. City of Fort Collins Purchasing Division 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 Sibelius CIC CRM/TM --- ACORD 25 (2010/05) © 1988-2010 INS025 (201005).01 The ACORD name and logo are registered marks of ACORD All rights reserved.