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Home My WebLink About201461 CONSTRUCTION CONCEPTS INC - INSURANCE CERTIFICATE (2)ACORD CERTIFICATE OF LIABILITY INSURANCE rM DATE24/2013 06/24/2013 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: Karole Peters Ewing -Leavitt Insurance Agency 9 4025 St. Cloud Dr. PHONE_ 970.679.7355 AIC,No Ext): AC No):866.237.2178 ADDRESS;J:karole-peters@leavitt.com Suite 100 Loveland, CO 80538 ��(��' INSURER(S) AFFORDING COVERAGE NAIC II INSURER A: Cincinnati Insurance Co 10677 INSURED Construction Concepts Inc INSURER : Pinnacol Assurance 41190 14125 Mead Street INSURER : OneBeacon Insurance Company 21970 Longmont, CO 80504 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 12-13 w WC update 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�S INSR WVO POLICY NUMBER PODCYEF MMRIDIYYYY POLICYE%P MMIDDNYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X Blkt Addl Insured EPP0162368' 10/01/2012 10101/2013 EACHOCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 500,000 MEDEXP(Any an. person) $ 10,00 PERSONAL &ADV INJURY $ 1,000,000 X Blkt Waiver of Sub GENERAL AGGREGATE Is 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECOT LOC PRODUCTS-COMP/OP AGG $ 2,000,00 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS %t NON -OWNED EBA0162368110/01/2012 10101/2013 Ea d=)bINGLE LIMIT S 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY Per accident ( ) $ X Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE EPP016236810/01/2012 10/01/2013 EACH OCCURRENCE $ 2,000,00 AGGREGATE $ 2,000,00 DIEDX RETENTION$ 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVEI�I OFFICERIMEMBER EXCLUDED? u (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 403174507101I2013 BLANKET WAIVE OF SUBROGATION 07/01I2014 X - TH- TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 'Commercial C Builders Risk Reporting Form 790010305'10/01/2012 10101/2013 $1,500,000 Any One Structure $1,000 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addidonal Remarks Schedule, if more space Is required) City of Fort Collins Purchasing Division 215 N. Mason Street 2nd Floor 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. /<.A..Ie ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD All rights reserved_