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HomeMy WebLinkAbout442066 MARTIN/ MARTIN INC - INSURANCE CERTIFICATEMART&MA-01 SMITHA '4`�R"' CERTIFICATE OF LIABILITY INSURANCE DA6/21/DD/YYYY) /21/2013 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 IOA436 Insurance Services -SD 4350 La Jolla Village Drive, Suite 900 San Diego, CA 92122 CONTACT NAME: INC.NONE 619 574-6220 F'ix ( No, Ep): ( ) (uc, Nol: (619) 574.6268 ADDRESS: INSURERS) AFFORDING COVERAGE NAICd 1 1„ INSURER A: Charter Oak Fire Insurance Company 25615 INSURED i71C3 Travelers Pro INSURER B: party Casualty Company of America 25674 INSURER C: Travelers Indemnity Company 25658 Martin/Martin, Inc. INSURER D:Valley Forge Ins Co 20508 12499 West Colfax Avenue Denver, CO 80215 INSURER E: Starr Surplus Lines Ins CO 13604 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 ADDL SUB R POLICY EFF POLICY EXP LTq TYPE OF INSURANCE INSR VND POLICY NUMBER (MwDDMIYYI, Al!MmOrYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1.000,000 A X COMMERCIAL GENERAL LIABILITY 6802275L118 611/2013 611/2014 -DAMAGE RENTED PREMISES Ea ocwrrence)_ S 300,000 CLAIMS-MADElxl OCCUR MED EXP(Any we Pemon) $ 5,000 PERSONAL&ADVINJURY $ 1,000,000 GENERAL AGGREGATE ($ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP,OP AGG E 2,000,000 POLICY X JEa �I LOC Is AUTOMOBILE LIABILITY COMBINEDSINUUh OMIT 1,000,000 (EaacadeM E B X ANY AUTO BA7846LB48 6/1/2013 61112014 BODILY INJURY (Per person) is ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per amdenl) $ NON-0NMED HIRED AUTOS AUTOS _ PROPERTVDAMAGE -PER ACCIDENT) E E X UMBRELLA UAS X OCCUR EACH OCCURRENCE E 9.000,000 AGGREGATE E 9,000,000 C EXCESS LUIS CLAIMS -MADE CUP3DO32440 6/1/2013 6/1/2014 DED I X I RETENTION$ 10,000 $ WORKERS COMPENSATION W'C STATD- OTH- X TORV LIMITS ER AND EMPLOYERS' LUIBIUTY YIN E.L. EACH ACCIDENT D ANY PROPRIETORMARTNEWEXECUTIVE OFFICER,MEMBER EXCLUDED' MIA 5091225203 611/2013 6/112014 E 1,000,000 EL DISEASE - EA EMPLOYEE $ 1,000,000 (Mandator In NH) If yyes, dearnbe under E.L. DISEASE - POLICY LIMIT I E 1,000,000 DESCRIPTIONOFOPERATIONS W. E Professional Liab SLSLPRO12153613 6/112013 6/1/2014 lPerClaim 2,000,000 E Deductible - $50,000 611I2013 6/112014 Aggregate 3,000,000 �SLSLPRO12153613 DESCRIPTIONOFOPERAnONS/LOCATIONSIWMICLES IAnach ACORDIDI,AWMonal Rar &C de ,Nmonapacalarpeind) Re: REP 7494 Parking Structures Conditions Assessments The City of Fort Collins, its officers and employees is/are Additional Insured(s) with respect to General Liability as required by Written contract. CERTIFICATE HOLDER CANCELLATION 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 City of Fort Collins 215 N. Mason 2nd Floor iFort Collins„ CO 80524 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD Named Insured: Martin/Marlin, Inc. Policy Number: 6802275LI18 COMMERICAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED (ARCHITECTS, ENGINEERS AND SURVEYORS) This endorsement modifies. insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. The following is added to WHO IS AN INSURED (Section II): Any person or organization that you agree in a "contract or agreement requiring insurance" to in- clude as an additional insured on this Coverage Part, but only with respect to liability for "bodily in- jury", "property damage" or 'personal injury" caused, in whole or in part, by your acts or omis- sions or the acts or omissions of those acting on your behalf: a. In the performance of your ongoing opera- tions; b. In connection with premises owned by or rented to you; or c. In connection with "your work" and included within the "products -completed operations hazard". Such person or organization does not qualify as an additional insured for "bodily injury", 'property damage" or "personal injury" for which that per- son or organization has assumed liability in a con- tract or agreement. The insurance provided to such additional insured is limited as follows: d. This insurance does not apply on any basis to any person or organization for which cover- age as an additional insured specifically is added by another endorsement to this. Cover- age Part. e. This insurance does not apply to the render- ing of or failure to render any 'professional services". f. The limits of insurance afforded to the addi- tional insured shall be the limits which you agreed in that "contract or agreement requir- ng insurance" to provide for that additional insured, or the limits shown in the Declara- tions for this Coverage Part, whichever are less. This endorsement does not increase the limits of insurance stated in the LIMITS OF INSURANCE (Section 111) for this Coverage Part: B. The following is added to Paragraph a. of 4. Other Insurance in COMMERCIAL GENERAL LIABILITY CONDITIONS (Section IV): However, if youspecifically agree in a "contract or agreement requiring insurance" that the insurance provided to an additional insured under this Cov- erage Part must apply on a primary basis, or a primary and non-contributory basis, this insurance is primary to other insurance that is available to such additional insured which covers such addi- tional insured as a named insured, and we will not share with the other insurance, provided that: (1.) The "bodily injury" or 'property damage" for which coverage is sought occurs; and (2) The 'personal injury" for which coverage is sought arises out of an offense committed; after you have entered into that "contract or agreement requiring insurance'. But this insur- ance still is excess over valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the insured when the insured is an additional insured under any other insurance. C. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us in COMMERCIAL GENERAL LIABILITY CON- DITIONS (Section IV): We waive any rights of recovery we may have against any person or organization because of payments we make for "bodily injury", 'property damage' or 'personal injury" arising out of "your work" performed by you, or on your behalf, under a "Contract or agreement requiring insurance' with that person or organization. We waive these rights only where you have agreed to do so as part of the "contract or agreement requiring insur- ance' with such person or organization entered into by you before, and in effect when, the "bodily CG D3 81 09 07 © 2007 The Travelers Companies, Inc. Page 1 of 2 includes the copyrighted materiel of Insurance. Services office, Inc.., with its permission. COMMERICAL GENERAL LIABILITY injury' or "property damage" occurs, or the "per- erage Part, provided that the "bodily injury' and sonal injury' offense is committed. 'property damage" occurs, and the'"personal in- D. The following definition is added to DEFINITIONS jury" is caused by an offense committed: (Section V): a. After you have entered into that contract or "Contract or agreement requiring insurance" agreement;. means that part of any contract or agreement un- b. While that part of the contractor agreement is der which you are required to include a person or in effect; and organization as an additional insured on this Cov- c. Before the end of the policy period. Page 2 of 2 © 2007 The Travelers Companies, Inc. CG D3 81 09 07 Includes the copyrighted material of Insurance Services Once, Inc., with its permission. Named Insured: Marfin/Martin, Inc. Policy, Number: BA78461_848 COMMERCIAL AUTO. THIS ENDORSEMENT CHANGES THE POLICY' PLEASE READ IT CAREFULLY. AUTO COVERAGE PLUS. ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS.AUTO COVERAGE FORM With respect to coverage provided by this endorsement: the provisions of the Coverage Form applyunless modi- fied by the endorsement. GENERAL DESCRIPTION OF COVERAGE - This endorsement broadens:coverage. However, coverage for any 'injury,:damageormedical expenses described in any of the provisions of,this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions_do not,apply'to the extent that coverage is excluded or limited by such an' endorsement. The following listing is a general cover- age description only.. Limitations.and exclusions, may Iapply to these, coverages: Read all,the provisionsof this en- dorsement and,the rest of .your carefully to determine, rights', duties„and what is and is not covered. A. ,BLANKET ADDITIONAL.INSURED H. AUDIO; VISUAL AND DATA ELECTRONIC B. EMPLOYEE HIRED AUTO C. EMPLOYEES.AS INSURED D. SUPPLEMENTARY PAYMENTS - INCREASED LIMITS. E. TRAILERS -.INCREASED LOAD CAPACITY F. HIRED AUTO PHYSICAL:DAMAGE G. PHYSICAL DAMAGE - TRANSPORTATION EXPENSES —INCREASED LIMIT A. BLANKET ADDITIONAL, INSURED The following is added. to Paragraph AA., Who Is An Insured, of SECTION, II — LIABILITY COV,- ERAGE: Any person or organization who is required under .a written contract or agreement between you and, that person or organization, that is signed and executed by you before the "bodily injury' or "property damage occurs and. that is in effect during the policy period, to be named as an'addi- tional insured is an "insured" for Liability Cover- age, but only for damages to.which this insurance applies and only to the extent that person of or- �ganization qualifies as an "insured" under the Who Is: An Insured provision contained in Section II. B. EMPLOYEE.HIRED.AUTO The following is added to Paragraph A.1., Who Is An Insured, of SECTION II'— LI- ABILITY COVERAGE: An "employee" of yours is an "insured" while operating a covered 'auto" hired or rented under a contract or agreement in that "em- ployee's" name, with your permission, while EQUIPMENT — INCREASED LIMIT I. WAIVER OF DEDUCTIBLE. —GLASS J. PERSONAL EFFECTS K. AIRBAGS L. AUTO LOAN LEASE GAP M. BLANKETWAIVEROF SUBROGATION. performing duties related to the conduct of your business., 2.. The following. replaces Paragraph b. in B.5., Other Insurance,, of SECTION N — BUSI- NESS.. AUTO CONDITIONS: 6.. For Hired Auto Physical Damage Cover- -age, thefollowing°are deemed to be cov- ered "autos" you own: (1)' Any covered. "auto" you lease; hire; rent or borrow; and (2) Any covered "auto"'hired or rented by your "employee" under a contract in that individual "employee's" name, with your permission, whileperform- 'ing duties- related to the conduct :of. your business'. _.However, any "auto"that is leased, hired, rented or borrowed_ with a driver is not covered "auto' C. EMPLOYEES AS INSURED The following is added to Paragraph A.1., Who Is, .An Insured, of SECTION II - LIABILITY COV- ERAGE, CA T4 20 07 10 © 2616 The Travelers Indemnity Company -Al rights reserved. Page 1' of Includes copyrighted material of Insurance Services Office; Inc: wdfi its'petrnission. COMMERCIAL AUTO Any "employee" of yours is an "insured" while us- ing a covered 'auto" you don't own, hire or borrow in your business or your personal affairs. D.:SUPPLEMENTARY PAYMENTS —INCREASED LIMITS 1. The following replaces Paragraph.A.2.a.(2) of SECTION II— LIABILITY COVERAGE: (2), Up to $3;000 for cost of bail bonds (in- cluding bonds for related traffic law viola- tions) required because of an "accident" we cover. We do not have to furnish these bonds. 2. The following replaces Paragraph A.2.a.(4) of SECTION 11=LIABILITY COVERAGE:. (4)All reasonable expenses incurred by the "insured"' at our request, including actual loss of .earnings up to'$500.a.day be- cause of time off from work:. E. TRAILERS—INCREASEDLOADCAPACITY The following. replaces Paragraph C.1..of SEC- TION I — COVERED AUTOS: 1. "Trailers" with a load capacity, of 3,000 pounds or less designed primarily for travel on public roads: F. HIRED AUTO PHYSICAL DAMAGE The following is addedtoParagraph, AA.-, Cover- age Extensions, of SECTION III'— PHYSICAL DAMAGE COVERAGE:, Hired. Auto. Physical, Damage Coverage If hired "autos" are covered "autos" for Liability Coverage but not covered "autos" for Physical Damage Coverage, and this policy also provides Physical Damage Coverage for an.owned "auto", then the Physical Damage Coverage is.extended to "autos" that you hire, rent or borrow subject to the following: (1): The most we will pay for "loss" in any, one "accident" to a hired, rented or borrowed "auto" is the lesser of: (a). $50,000: (b). The actual cash value of the damaged or stolen property as of the time of the "loss"; or (3) If a repair or replacement results in better than like kind or quality, we will not pay for the. amount of betterment. (4) A deductible equal., to the highest Physical, Damage deductibleapplicable'to any owned. .covered "auto". (5) This Coverage Extension does not apply to: (a) :Any "auto" that is hired; rented or bor- rowed with a driver, or (b) Any "auto" that is hired, rented or bor- .rowed.from•your "employee".. G. PHYSICAL DAMAGE — TRANSPORTATIONS. EXPENSES —INCREASED LIMIT The following. replaces the first sentence in Para- graph A,4.6., Transportation Expenses, of SECTION III — PHYSICAL DAMAGE COVER- AGE: - - .. We will pay up to $50 per day to a. maximum of $1,500 for temporary transportation expense.in- cubed by you because of the:total theft of a cov- ered."auto" of the private passenger type. H. AUDIO, VISUAL AND DATA ELECTRONIC. EQUIPMENT =,INCREASED LIMIT Paragraph C.2.. Limit Of Insurance, of SEC- TION III - PHYSICAL DAMAGE COVERAGE is deleted. I. WAIVEROFDEDUCTIBLE — GLASS The.following..isadded to Paragraph D., Deducti-: ble, of SECTION, III' — PHYSICAL DAMAGE. COVERAGE: No deductible for a covered "auto" will apply to glass. damage if the glass is repaired rather than replaced. PERSONAL EFFECTS The following is added to Paragraph A.4., Cover-, age Extensions, of SECTION III PHYSICAL DAMAGE' COVERAGE: Personal Effects Coverage We will pay up to $400 for "loss" to wearing ap- parel and other personal effects which are: (1) Owned by'an "insured"; and (2) In or on your covered "auto". (c) The cost of repairing or replacing' the This coverage only applies: in the event of a total damaged or stolen property with other theft of your covered "auto". property of like kind and quality. No deductibles apply to Personal Effects cover- (2) An adjustment for depreciation and physical age. condition will be made in determining actual cash value in the event of.a total "loss". Page 2 of 3 0.2010 The Travelers Indemnity Company. Al rights reserved. CA T4.20 07 10 Includes copyrighted material of Insurance services Office, Inc. with its permission. K. AIRBAGS The following is added to Paragraph B.3., Exclu- sions, of SECTION III — PHYSICAL DAMAGE COVERAGE: Exclusion 3.a. does riot apply to 'loss" to one or more airbags in a covered "auto"'you own that in- flate due. to a cause other than a cause, of "loss" set forth in Paragraphs .A.l.b. and A.1.c.-, but only: a. If that "auto" is.a covered "auto' for Compre- .hensive. Coverage under this policy; b. The airbags are not covered under.any-war- ranty: and c. The airbags=were not intentionally inflated. We will pay up to a maximum of $1;000 for any one "loss". L...AUTO LOAN LEASE GAP The following is-.added,to Paragraph A_.4., Cover- age Extensions; of SECTION .III - PHYSICAL DAMAGE COVERAGE: Auto Loan .Lease Gap Coverage for Private Passenger Type•Vehicles .In the event of a total."loss" to a covered "auto" of :the private passenger type shown.in the Schedule or Declarations for which Physical Damage Cov- erage is provided, we will pay, any unpaid amount due on the lease or loan for such covered "auto" less the following: (1) The amount pad,under;the Physical.Damage Coverage Section' of the policy for that "auto'; and COMMERCIAL AUTO (2) Any: (a) Overdue lease or loan payments at the time of'the "loss (b) .Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (c) Security deposits not returned by the les- sor; (d) 'Costs for extended warranties; Credit Life Insurance, Health, Accident or Disability .Insurance purchased with the loan or lease; and (e) Carry-over balances. from, previous loans or leases. M. BLANKET'WAIVER.OF SUBROGATION The following replaces Paragraph A.5., Transfer Of. Rights Of Recovery Against Others To Us, of SECTION IV — BUSINESS. AUTO COi TIONS: 5. Transfer Of Rights Of Recovery Against ,Others To Us. We waive any right of recovery we may have against any person or organization to the ex- tent required of you by a written contract exe- cuted prior .to: any "accident" or "loss', pro- vided.that the "accident' or "Ioss7 arises out of the operations contemplated by such con- tract. The waiver applies only to theperson or organ ization•designated in such contract CA T4 20 07 10 02010 The Travelers Indemnity Company. Al rights reserved. Page 3 of 3 Includes copyrighted material of Insurance services Office, Inc. with its permission. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT WC000313 (Ed. 4-84) We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule. Per the attached certificate This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement. Effective 06/01/2013 Policy No. 5091225203 Endorsement No. Insured: Martin/Martin, Inc. Premium $ Insurance Company: Valley Forge Ins. Co. WC 00 03 13 (Ed. 4-84) Countersigned by Copyright 1983 National Council on Compensation Insurance: