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HomeMy WebLinkAbout380591 J2 CONTRACTING COMPANY INC - INSURANCE CERTIFICATE (2)Client#: 45027 aj-r.T em ACORD,, CERTIFICATE OF LIABILITY INSURANCE DATEIYYYY) 12/17/207/2013 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 Flood & Peterson Ins., Inc. P. O. Box 578 Greeley, CO 80632 970 356-0123 NOVAE: NTACT Nancy Keiser PN 970 356-0123FAX A/c No), 9705066836 E#WL nkeiser@floodpeterson.com AWRESS: INSURER(S) AFFORDING COVERAGE NJ000 INSURER A: Travelers Insurance Company INSURED ^ IIf /X I J2 Contracting Company, Inc. %$QLJ� PO BOX 129 v INSURER e : INSURER C: Greeley, CO 80632 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 REDUCED BY PAID CLAIMS. IN3R LTR TYPE OF INSURANCE ADDL NOR SUSR WVD POLICY NUMBER POLICY EFF MWDO POLICY UP MIDD/YYYY users A GENERALLUIBILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X PD Ded:2,500 DTC032SD6576IND14 1 1/0112014 01/01/2011 EACHp OCCURRENCE $1 OOOOOO PRELfMI PE RENTED 000,000 NED UP (Any one non) $S 000 PERSONAL & ADV INJURY $1 000 000 GENERAL AGGREGATE s2 000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 17 POLICY PRO- 71 LOC PRODUCTS -COMPIOP AGO $000,000 s A AUTOMOBILE LIABILITY IANYAUTOBODILY ALL OWNED SCHEDULED AUTOSAUTOSIREO AUTOS X NON -OWNED AUTOS Oth Car 81032SD6576TIL14 1/01/2014 01/01/201 COMBINED SINGLE LIMIT Ma e Gtlent 1,000,000 INJURY (Per Person) s BODILY INJURY (Per socident) s $ PROPERTY DAMAGEs Per acdcantrlvs A UMBRELLALIAB EXCESS LIAS OCCUR CLAIMS -MADE CUP325DO576TIL14 1/011/2011401/01/201 EACHOCCURRENCE s4000000 _ f4 OOO 000 AGGREGATE DED X RETENTION s1 O 000 Is WORKERS COMPENS MON AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICENIMEMBER CLUDED? (Mandatory In NH) I/ys.. tlaacr0e under 0 SCRIPTION OF OPERATIONS below I WC STATU- OTH- E.L. EACH ACIDE s E.L. DISEASE -EA EMPLOYEE s E.L. DISEASE -POLICY LIMIT - s A Leased/Rented Equipment QT6607225L939TIL14 1/01/2014 01/0112011 $750,000 Died. $1,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarin Schedule, If more space is required) Cit of Fort Collins is named as an additional insured in regard to the general liability policy per policy terms and conditions in regard to the 7209 Registry Neighborhood Park; Fort Collins CO project. City of Ft Collins 215 North Mason Street 2nd Floor 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 ACORD 25 (2010/05) 1 off #S847539/M845337 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ARP Client#: 45027 JTWOC ACORD.. CERTIFICATE OF LIABILITY INSURANCE D12/172013UE YY) 12117/2013 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. N 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 Flood & Peterson Ins., Inc. P. O. Box 578 Greeley, CO 80632 970 356-0123 NAME; CT Nancy Keiser " r; ea; 970 356-0123 FAX JAIC Ne, 9705066836 ADDDRESS: nkeiser@floodpeterson.com INSURER(3)AFFORDING COVERAGE NAICB INSURER A: Travelers Insurance Company _ INSURED J2 Contracting Company, Inc. PO Box 129 INSURER B : INSURER C: Greeley, CO 80632 NBURER 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 REDUCED BY PAID CLAIMS. INSRLTR TYPE OF mSURANCE ODL SU POLICY NWBER POLICY EFF POL OY EXP UNITS A GENERALUABILRY X COMMERCIAL GENERAL UABIUW CLAIMS -MADE FxI OCCUR X PD Ded:2,500 DTC032506576IND14 0110112014011011201 EACH OCCURRENCE s1000000 PRES EeE mEiOmwa1 s3000OO MED EXP (Any one persw) ES 000 PERSONAL S ADV INJURY E 1 00O 000 GENERAL AGGREGATE s2 000 0O0 GEN'LAGGREGATE POLICY LIMIT APPLIES PER: PROJECT- 71 LOC PRODUCTS -CONI AGO s2000000 $ A AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS X HIR �SAUr05 X NOON -OWNED AUTOS X rive Otlt Car 810325D6576TIL14 1/01/2014 01/01/201 COMBINED SINGLE LIMIT 1,000,000 BODILY INJURY (Par person) E BODILY INJURY (Per aaadent) S PROPERTY DAMAGE Per seacoast)$ E A LAB EXCESS LIAS OCCUR C W MS•MADE CUP325D6576TIL14 1/011201401/01/201 EACH OCCURRENCE E4000000 dUMBRELLA AGGREGATE E4 OOO OOO DED I X RETENTION E1 O OOO E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N OFFICER(MEMBER EXCLUDED ECUTIVE❑ (Mandatory In NH) If yee, desodbeunder DESCRIPTION OF OPERATIONS below NIA I WC STATU- I OTH- FR E.L. EACH ACCIDENT E E.L. DISEASE - EA EMPLOYEE E E.L. DISEASE -POLICY LIMIT $ A Leased/Rented Equipment QT6607225L939TIL14 1/01/2014 01/01/201 $750,000 Ded.$1,000 DESCRIPTION OF OPERATIONS I LOCATIONS) VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) The City of Fort Collins is named as Additional Insured as respects the General Liability and Builders Risk only if requred by written contract and coverage applies only as respects to work performed by the Insured for the Additional Insured for the 7434 Reservoir Ridge Natual Area Improvements. City of Fort Collins 215 N. Mason Street 2nd Floor 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. ACORD 25 (2010/05) 1 of 1 #S847535/MB45337 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ARP