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HomeMy WebLinkAbout113060 MOUNTAIN CONSTRUCTORS INC - INSURANCE CERTIFICATE (4)Client#: 67322 8MOUNCON2 ACORD,. CERTIFICATE OF LIABILITY INSURANCETE D7124/2/DD/YYYY) /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 Willis of Colorado, Inc. 2000 South Colorado Boulevard Tower II, Suite 900 Denver, CO 80222 D CONTACT NAME: PHONE 303 722-7776 FAX 303-722-8862 AIC, No, Ext : A/C, No E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC 0 INSURER A: Charter Oak Fire Insurance Comp 25615 INSURED Mountain Constructors, Inc. 622 Main Street INSURER B: Travelers Property Casualty Corn 36161 INSURER CPinnacol Assurance 41190 PO Box 405 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 INSURANCE ADDLSUBR INSR WVD POLICY NUMBER POLICY EFF (MDD/YYYY) M/ POLICY EXP MM/DD/YYYY LIMITS _ A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx_] OCCUR X PD Ded: $1,000 X DTC0325D62511ND13 7/28/2013 07/28/2014 EACH OCCURRENCE $1 000000 PREMISES Ea ocT5Dence $300 000 MED EXP (Anyone person) s5,000 PERSONAL &ADV INJURY $1,000,000 X CGD24608/05 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 1-1 POLICY X PROJECT LOC PRODUCTS - COMP/OP AGG $2,000,000 $ B AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X HIRED AUTOS X NON -OWNED AUTOS DT810391 BRO04TIL13 7/28/2013 07/28/2014 COMBINED SINGLE LIMIT Ea accident 1 OOO OOO $ , r BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTYDAMAGE Per accident $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE DTSMCUP3918RO04TIL 7/28/2013 07/28/2014 EACH OCCURRENCE s2,000,000 AGGREGATE s2,000,000 DED I X RETENTION $$1O 000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? N (Mandatory In NH) if yes, describe under DESCRIPTION OF OPERATIONS below N/A 3027994 7/01/2013 07101/2014 X WC STATU- OTH- E.L. EACH ACCIDENT $1 OOO 000 E.L. DISEASE- EA EMPLOYEE1 $1 000 000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if 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 ��1♦ ACORD 25 (2010/05) 1 of 2 #S1050459/M1050453 ©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 (2010/05) 2 of 2 #S1050459/M1050453 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE. POLICY. PLEASE READ IT CAREFULLY BLANKET A.DDITICNAL INSURED (CONTRACTORS) This endorsement modifies insurance provided.under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1, WHO IS AN INSURED — (Section I1) 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 you or your sub n ac or to the purfurrrmrrm of "your work" to which the "written contract requiring insurance" applies. The person or organization does not qualify 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) b) 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- surarice provided to the additional insured shall be limited to the limits of liability re- quired by that "wdtten contract requiring in- surance". This endorsement shall not in- crease the limits of insurance described in Section III —Limits Of Insurance. The insurance provided to the additional in- sured does not apply to "bodily injury", " pro 1p- erty damage" or "personal injury" arising oyt 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- - -ders 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 beTore­the end of the period of 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 Oc 2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITY i. How, when and where the "occurrence" or offense took place; ii. The names and addresses of any injured persons and witnesses; and iii. The nature and location of any injury or damage arising out of the "occurrence" or offense_ b) If a claim is made or "suit" is brought against the additional insured, the additional insured must: i. Immediately record the specifics of the claim or "suit" and the date received; and ii. Notify us as soon as practicable. The additional insured must see to It that we receive written notice or the claim or "suit" as soon as practicable. c) The additional insured must immediately send us copies of all legal papers received in connection with the claim or "suit", cooperate with us in the investigation or settlement of the claim or defense against the "suit", and otherwise comply with all policy conditions. d) The additional insured must tender the de- fense and indemnity of any claim or "suit" to any provider of "other insurance" which would cover the additional insured for a loss we cover under this endorsement. However, this condition does not affect whether the insur- ance provided to the additional insured by this endorsement is primary to "other insur- ance" available to the additional insured which covers that person or organization as a named insured as described in paragraph 3. above. 5. The following definition is added to SECTION V. — DEFINITIONS: "Written contract requiring insurance" means that part of any written contract or agreement under which you are required to include a person or organization as an additional in- sured on this Coverage Part, provided that the "bodily injury" and "property damage" oc- curs and the "personal injury" is caused by an offense committed. a. After the signing and execution of the contract or agreement by you; b. .While that part of the contract or agreement is in effect; and c. Before the end of the policy period. Page 2 of 2 © 2005 The St. Paul Travelers Companies, Inc. CG D2 46 08 05 003369