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Home My WebLink AboutLEFT HAND EXCAVATING LLC - INSURANCE CERTIFICATEClient#: 53412 BLEFTHAN1 ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE 11/18/20138/2013 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 pollcy(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 11, Suite 900 Denver, CO 80222 CONTACT NAME: ai"rioekt,303722-7776 A�pp:303-722-8862 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIL p INSURER A: OBE Insurance Corp 39217 INSURED Left Hand Excavating, LLC 7733 N 73rd Street INSURER B: Pinnecol Assurance 41190 INSURER C : Atlantic Specialty Insurance 27154 Longmont, CO 80503 INSURER D: 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 BYPAIDCLAIMS. INSLTRR TYPE OF INSURANCE INSR S� POLR:YNUMSER ppRppEDUCED AMID YEFF MWO P LIMITS A GENERAL LIABILITY CC11174022 1/17/2013 1111712014 $1000000 X COMMERCIAL GENERAL LIABILITY EEpAApCCL1H��OEECTCT'URRIyRENCE PREMISESOEaE�Ei ante $100000 CLAIMS -MADE F—R OCCUR MED EXP lAny one person) $1 O 000 PERSONALS ADV INJURY $1,000000 X PD Ded:1,000 X CG 8156 03 09 GENERAL AGGREGATE 52,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2000,000 POLICY X PRO- LOC JECTA $ AUTOMOBILE LIABILITY CBA1174020 1/17/2013 11/17/201 Ea �d DISINGLE LIMIT 1,000,000 BODILY INJURY (Per person) S X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X HIRED AUTOS X NON -OWNED AUTOS BODILY INJURY (Per accident) S PROPERTY DAMAGE Par acdtlent $ $ A UMBRELLA LIAB OCCUR CCU1174021 1117/2013 11/17/2014 EACHOCCURRENCE $1000000 X N AGGREGATE $1 OOO 000 EXCESS UAB CLAIMS -MADE DED I X RETENTION O $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYER ANY PROPRIETOMPARTNER/EXECUTIVE YI N OFFICER/MEMBER EXCLUDED? 7 (Myandatory In NH) NIA 1663960 1/01/2013 01/01/201 X WC STAM, OTH- E.L. EACH ACCIDENT $500000 E.L. DISEASE - EA EMPLOYEE $50O OOO orr DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $500 000 C Installation 7900067540005 1/17/2013 11/17/2014 $250,000 Per Project Floater $5000OTempStorag*&Trans $1,000 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, McIltional Remarks Schedule, if more apace Is ralulred) Project Description: Right of Way Contractor's License The following are Additional Insureds as respects General Liability only to the extent coverage might apply according to the policy terms, conditions and exclusions. Consult the policy to determine extent of (See Attached Descriptions) City of Fort Collins P O Box 580 Fort Collins, CO 80522-0580 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 ACORD 25 (2010105) 1 of 2 #Sl072551IM1072497 V 1Ut1e4UlU AUUKU UUKYUKAI IUN. All rlgms reserveo. The ACORD name and logo are registered marks of ACORD 8TBEC DESCRIPTIONS (Continued from Page 1) coverage. This Certificate confers no rights on the Certificate Holder. Additional Insureds: City of Fort Collins SAGITTA 25.3 (2010/05) 2 of 2 #S1072551IM1072497 COMMERCIAL GENERAL LIABILITY CG 81 54 03 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES, CUSTOMERS OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN WRITTEN AGREEMENT WITH YOU This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE NAME OF PERSON OR ORGANIZATION DESIGNATED PROJECT NAME OR NUMBER BLANKET AS REQUIRED BY CONTRACT A. Section II — Who is an Insured is amended to include as an additional insured any person or organization, including any person or organization shown in the schedule above, for whom you are performing operations when you and such person or organization have agreed In writing in a contract or agreement (as set forth in Paragraph B. below) that such person or organization be added as an additional insured on your policy. Such person or organization is an additional insured only with respect to liability for "bodily injury", "property damage", or "personal and advertising injury" caused in whole or in part by. 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the additional insured. A person's or organizabon's status as an additional insured under this endorsement ends when your operations for that additional insured are completed. B. Additional Conditions 1. The written contract or written agreement must be: a. Currently in effect or becoming effective during the tens of this poky,, and b. Executed prior to the "bodily injury", "property damage" or "personal and advertising injury'. 2. The Limits of Insurance applicable to the additional insured are those specified in the written contract or agreement or in the Declarations of this policy, whichever is less. These Limits of insurance are inclusive of and not, In addition to, the Limits of Insurance shown in the Declarations. C. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: Includes copyrighted material of Insurance Services Office, !nc. CG 8154 03 09 with its permission. Page 1 of 2 This insurance does not apply to: 1. "Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including but not limited to: a. The preparing, approving or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; or b. Supervisory, inspection, architectural or engineered activities. 2. "Bodily injury" or "property damage" occurring after. a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance, or repairs) to be performed by or on behalf of the additional insured(s) seeking coverage at the location of the covered operations has been completed; or b. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. D. As respects the coverage provided by this endorsement, Paragraph 4.a. Section IV Commercial General Liability is deleted and replaced by: 4. Other Insurance a. This insurance is primary except when b. Wow applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in G below. When required by written contract or agreement with the additional insured, this insurance Is primary and we will not share under Paragraph c. below with the additional insured. Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 2 with its permission. CG 81 54 03 09