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109014 RC HEATH CONSTRUCTION CO - INSURANCE CERTIFICATE
Client#: 25306 HEAC04 ACORD,w CERTIFICATE OF LIABILITY INSURANCE 9/23/2013 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: H the certificate holder is an ADDITIONAL INSURED, the policy(kids) must be endorsed. If SUBROGATION IS WANED, 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 endomement(s). PRODUCER CANT" T Cindy Zimmerman Flood & Peterson Ins., Inc. PA"oNNeo Eat):970-266-7155FAX AICNo:970-506-6845 P. O. Box 578 ADDRESS, CZimmerman@floodpeterson.com Greeley, CO 80632 INSURERS) AFFORDING COVERAGE NNti 970 356-0123 ,wA„.Fy A . Zurich American Ins. Co. INSURED INSURERS: Plnnacol Assurance R. C. Heath Construction Co. 0 9 0 NSURER C : dba Heath Construction INSURER D PO Drawer H INSURER E: Fort Collins, CO 80522 INSURER F: CrIvic .FS CFRTIFICATF NIIMRFR- 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. INSIR LTR TYPE OF INSURANCE DLSUSR N R WVD POLICY NUMBER POLICY EM MM/DO POLICY UP MM/DDNM LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7OCCUR X PO Ded: 5,000 CP0583316401 11913012013 0913012014 EACH OCCURRENCE s 1 OOO OOO pgEEe car en EttlR 8300 000 MEDUPM aria non $10000 PERSONAL SADV INJURY E1 000 000 GENERAL AGGREGATE 32000,000 GEN'L AGGREGATE 17 POLICY 7X LIMIT APPLIES PER: PRO LOC PRODUCTS - COMP/OPAGG s2000,000 $ A AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOX HIREOSAUTOB X OS NEON -OWNED AUTOS CP0583316401 /30/201309/30/201 COMBidep.0 NGLE LIMIT 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Par accident) $ PROPERTYDAMAGE per aadanl $ S A X UMBRELLA LU1B EXCESS LIAS OCCUR CLAIMS -MADE AUC583319601 /30/2013 09/3012014 EACH OCCURRENCE f6 000 000 N AGGREGATE 36 O00 000 DIED I X1 RETENTIONSO S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERJUECUTIVE —] OFFICER(MEMSER EXCLUDED? (Mandatory In NH) If yea, describe under DESCRIPTION OF OPERATIONS be. NIA 4033691 0/01/2013 10/01/201 X WC STATU- OTH- E.L. EACH ACCIDENT $1000000 E.L. WSEASE - EA EMPLOYEE $1000000 E.L. DISEASE -POLICY LIMIT $1000000 DESCRIPTION OF OPERATIONS LOCATIONS / VEHICLES (Attach ACORD 1111, Additional Remarks Schedule, if more space is required) Re: 7426 Transfort Maintenance Facility Expansion Project Certificate holder is included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named insured. City of Ft Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO BOX 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) 1 Of 1 The ACORD name and logo are registered marks of ACORD #S829117/M829059 CAZ