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HomeMy WebLinkAbout113060 MOUNTAIN CONSTRUCTORS INC - INSURANCE CERTIFICATE (3)Client#: 67322 8MOUNCON2 ACORD,., CERTIFICATE OF LIABILITY INSURANCE DATE 710D/YYYY) /13I2013 /13/2 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: Willis of Colorado, Inc. a°,"N E,t: 303 722-7776 FAX, pJq; 303-722-8862 2000 South Colorado Boulevard E-MAIL Tower II, Suite 900 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # Denver, CO 80222 T, D INSURER A: Travelers Indemnity Company 25658 INSURED INSURER B: Travelers Property Casualty Corn36161 Mountain Constructors, Inc. 41190 Black Mountain Builders INsuRERc:PinnacolAssurance PO Box 405 622 Main Street INSURER D : Platteville, CO 80651 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 CONTRACTOR 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 ADDLSUB INSR MD POLICY NUMBER POLICY EFF MMIDD POLICY EXP MMIDD/Yl ) LIMBS A _ GENERALLIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1*1 OCCUR X1 Ltd Pollution X DTC0325D62511ND12 7/28/2012 07/28/2013 EACH OCCURRENCE $t 000,000 PREMISES TORENTED$300000 MED EXP (Any one person) $ 5 000 PERSONAL B ADV INJURY $1,000,000 X AI# CG D2 46 08/05 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X JEGT LOG... PRODUCTS - COMPIOP AGG $2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIREDAUTOS X NON -OWNED AUTOS Ltd Pollution DT8103918RO04TIL12 7/28/2012 07/28/2013 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X X PROPERTY DAMAGE Per accident $ $ B X UMBRELLA LIAS EXCESS LIAB X OCCUR CLAIMS -MADE DTSMCUP3918R004TIL D712812012 07/28/2013 EACH OCCURRENCE $1 000000 AGGREGATE $1 OOO 000 DED I X RETENTION $1 O 000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? IN Mandatory In NH) descril,e under DESCRIPTION OF OPERATIONS below NIA 3027994 7/01/2013 07/01/201 X WCSTATu- OTH- CRY E.L. EACH ACCIDENT $1 000 000 t LOYEE E.L. DISEASE- EA EMPes. $If 1 OOO 000 E.L. DISEASE -POLICY LIMIT 81,000:000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more space Is required) Project Description: 7277 Intersection Improvements at Harmony & Lemay and Drake & Lemay The following are Additional Insureds as respects General Liability only if required by written contract and coverage applies only as respects (See Attached Descriptions) City of Fort Collins 300 Laporte Ave. 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 =l_� ACORD 25 (2010105) 1 of 2 #Sl048432/M1048194 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 8VMAN DESCRIPTIONS (Continued from Page 1) work performed by the Insured for the Additional Insureds. All coverage terms, conditions and exclusions of the policy apply. Additional Insureds: State of Colorado The Additional Insured endorsement which is referenced above under "Type of Insurance -General Liability" is attached. SAGITTA 25.3 (2010105) 2 of 2 #S1048432IM1048194 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE. POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided. under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1, WHO Is AN INSURED — (Section II) is amended to include any person or organization that you agree in a "written contract requiring insurance" to include as an additional insured on this Cover- age Part, but: a) Only with respect to liability for "bodily injury", "property damage" or "personal injury'; and b) If, and only to the extent that, the injury or damage is caused by acts or omissions of yo r c n of "your work" to which the "written contract requiring insurance" applies. The person or organization does not quality as an additional insured with respect to the independent acts or omissions of such person or organization. 2. The insurance provided to the additional insured by this endorsement is limited as follows: a) In the event that the Limits of Insurance of this Coverage Part shown in the Declarations exceed the limits of liability required by the "written contract requiring insurance", the in- surance provided to the additional insured shall be limited to the limits of liability re- quired by that "written contract requiring in- surance". This endorsement shall not in- crease the limits of insurance described in Section Ill— Limits Of Insurance. b) The insurance provided to the additional in- sured does not apply to "bodily injury", " Pro 1p- erty damage" or "personal injury" arising out of the rendering of, or failure to render, any professional architectural, engineering orsur- veying services, including: i. The preparing, approving, or failing to prepare or approve, maps, shop draw- ings, opinions, reports, surveys, field or- -'dens or change orders, or the preparing, approving, or failing to prepare or ap- prove, drawings and specifications, and ii. Supervisory, inspection, architectural or engineering activities. c) The insurance provided to the additional in- sured does not apply to "bodily injury" or "property damage" caused by "your work" and included in the "products -completed op- erations hazard" unless the "written contract requiring insurance" specifically requires you to provide such coverage for that additional insured, and then the insurance provided to the additional insured applies only to such "bodily injury" or "property damage" that oc- curs Fef re the en o the period o time for which the "written contract requiring insur- ance" requires you to provide such coverage or the end of the policy period, whichever is earlier. 3. The insurance provided to the additional insured by this endorsement is excess over any valid and collectible "other insurance", whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss we cover under this endorsement. However; if the "written contract requiring insurance" specifically requires that this insurance apply on a primary basis or a primary and non-contributory basis, this insurance is primary to "other insurance" available to the additional insured which covers that person or organization as a named insured for such loss, and we will not share with that "other insurance". But the insurance provided to the additional insured by this endorsement still is excess over any valid and collectible "other in- surance", whether primary, excess, contingent or on any other basis, that is available to the addi- tional insured when that person or organization is an additional insured under such "other insur- ance". 4. As a condition of coverage provided to the additional insured by this endorsement: a) The additional insured must give us written notice as soon as practicable of an "occur- rence" or an offense which may result in a claim. To the extent possible, such notice should include: CG D2 46 08 05 © 2005 The St. Paul Travelers Companies, Inc. Page 1 of 2