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HomeMy WebLinkAbout157655 WATTLE & DAUB CONTRACTORS INC - INSURANCE CERTIFICATE (2)ACORO® CERTIFICATE OF LIABILITY INSURANCE- �i DATE (MMIDDlz/z7/z012 lz 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 Denver Agency Company 210 University Blvd, Suite 600 Denver CO B0206-4661 CONTACT Laura Mass NAME: PNDNE Per (303) 692-6900 FAX (303)892-6938 E-MAIL .laura@denveragency. com ADD INSURERS AFFORDING COVERAGE NAIC # INSURERA.Atain Specialty Ins CO %Burns 6 Wilcox INSURED jwfI Wattle S Daub Contractors, Inc. 8 Gibbs Rd. Laramie WY 82070 INSURERB:Charter Oak Fire IRS 25615 INSURER C:P1rlIlacol Assurance 41190 INSURER D: INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER:2013 Genl 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 MMIDDIYYYY) POLICY EXP (MMIDDNYYY1 LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR CIP143645 /1/2013 /1/2014 DAMAGE TO PREMISES Ea RENTED $ 50,000 MED EXP (Any one person $ 5,000 PERSONAL S ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN1 AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 17 POLICY X PRO LOC $ LIABILITY EOMBINdEDI SINGLE LIMIT 1,000,000 BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS -1281Y079-13-SEC /1/2013 /1/2014 POMOBILE BODILY INJURY(Per accident) $ PROPERTY DAMAGE Per accident $ MIRED AUTOS X NON -OWNED AUTOS Uninsured molonst combined $ 1 000,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ 1 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / NDRYANY PROPRIETORIPARTNERJEXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A 093011 /1/2013 /1/2014 X I WC STATIU I DTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yyes, describe under of SCPIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If 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 ACORD McKeever, CIC/LAURA ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 (201005).o1 The ACORD name and logo are registered marks of ACORD 111. 0 CERTIFICATE OF LIABILITY INSURANCE �/ ATE D2/27 2012)- 12/27/2012 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 Denver Agency Company 210 University Blvd, Suite 600 Denver CO 80206-4661 CONTACT Laura Mass NAME: PHONE (3O3)892-6900 FAX MIC Not.13031e92-6938 EMAIL .laura@denveragency.com INSURER $ AFFORDING COVERAGE NAIC It INSURERAAtain S l ialt Ins Co %Burns 6 Wilcox INSURED Wattle S Daub Contractors, Inc. 8 Gibbs Rd. Laramie WY 82070 INSURERB Charter Oak Fire Ins 25615 INSURER C Pinnacol Assurance 41190 INSURER O: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:2013 Genl Certs 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 J= UBR me POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MMIDD)YYYYJ LIMITS GENERALLIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE MOCCUR 2IP143645 /1/2013 /1/2014 DAMAGE TO R N PREMISES Ea n $ 50,000 MED EXP(Any one person) $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY EOMaBINEEDt SINGLE LIMIT 11000,000 BODILY INJURY (Per person) $ B XP ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS -1281YO79-13-SEL /1/2013 /1/2014 BODILY INJURY Per accident ( I $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS N AUTOS Uninsured motorist combined $ 1 000 000 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DIED I I RETENTION$ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOILPARTNER/EXECUrIVE OFFICER/MEMBER E%CLUDED? (Mandatory in Ni If yes, describe under NIA 4093011 /1/2013 /1/2014 X WC STATU- DTH- EL EACH, $ 1,000,000 E.L. DISEASE -EA EMPLOYE $ 1 000,000 EL DISEASE -POLICY LIMIT $ 1.000.000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Aflach ACORD 101, Additional Remarks Schedule, N more space Is required) Certificate Holder is included as Additional Insured regarding General Liability. , Re: 7406 Bobcat Ridge Historic Buildings Rehabilitation. City of Fort Collins Attn: Purchasing 6 Risk Management 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 ACORD 25 (2010/05) McKeever, CIC/LAURA 1988-2010 ACORD CORPORATION. All rights INS025 (20101 The ACORD name and logo are registered marks of ACORD