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HomeMy WebLinkAbout493755 KDG ENGINEERING LLC - INSURANCE CERTIFICATE (4)sic - CERTIFICATE OF LIABILITY INSURANCE DAT^^MM'DDIYYVV) 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 PRODUCER /an Gilder Insurance Corp. 1515 Wynkoop, Suite 200 )enver CO 80202 INSURED KDGENG Engineering, LLC 350 4�3�5� 3500 S. Wadsworth Blvd., Ste. 400 Lakewood CO 80235-0337 COVERAGES CERTIFICATE NUMBER: 222159744 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 CONTRACT OR 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. ILTR TYPE OF INSURANCE ADDL SUBS POLICY NUMBER POLICY EFF POLICY EXP OMITS GENERAL LIABILITY Y Y 34SBWS4819 2/15/2013 1211512014 EACH OCCURRENCE $1,000000 PRE Soocismincel 61,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [K ] OCCUR MED EXP (Any one pension) $10.000 PERSONAL S ADV INJURY 51,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2000,D00 $ POLICY X PRO- LOC A AUTOMOBILE LIABILITY Y Y 34SB11111548h9 2/152013 2/15/2014 Ea WINtU INUILLILIMIf 1000000 BODILY INJURY (Per parson) S ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (PareGdBM) $ PROPERTY DAMAGE Fereccidml NON -OWNED HIRED AUTOS AUTOS $M$111000000to)o UMBRELLA UAS X OCCUR Y 34SBNOS481B 2/152013 2/152014 EACH OCCURRENCE AGGREGATE EXCESS UAS CLAIMS -MADE DED X RETENTION $10,000 B WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNERMXECUTIVE OFFICER/MEMBER EXCLUDED? N/A Y 7GLVO499 2/1112013 2/152014 X WC STATU- OTH -E E.L EACH ACCIDENT E.L. DISEASE - EA EMPLOYE (Mandatory In NH) No describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMB 51000000 C Professional Liability N Y R9707885 2/15/2013 2/15/2014 Per Claim Limit $2,000,000 Claims Made Aggregate Limit $2.000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, AddKlonal Remarks Schedule, if mom space Is required) As required by written contract or written agreement, the following provisions apply subject to the policy terms, conditions, limitations and exclusions: The Certificate Holder and Owner are included as Additional Insureds for ongoing and completed operations under General Liability; Designated Insured under Automobile Liability; and Additional Insured under Umbrella / Excess Liability but only with respect to liability arising out of the Named Insured's work performed on behalf of the certificate holder and owner. This insurance will apply on a primary, non-contributory basis. A Blanket Waiver of Subrogation applies for General Liability, Automobile Liability, Umbrella/Excess Liability and Workers' Compensation. Limited Contractual Liability is included. The Umbrella / Excess Liability policy provides excess coverage over See Attached... City of Fort Collins PO Box 280 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. AUTHORIJfD © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: KDGENG LOC #: ACORN® ADDITIONAL REMARKS SCHEDULE Page t of AGENCY Van Gilder Insurance Corp. NAMEDINSURED KDG Engineering, LLC 3500 S. Wadsworth Blvd., Ste. 400 Lakewood CO 80235-0337 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: General Liability, Automobile Liability and Employers Liability. ject: P7260 Prospect Road Bridge and Mulberry Street Bridge Replacement Design Service litional Insured: City of Fort Collins and Colorado Department of Transportation I tIlWITIT:R1TiD n innRArnOnrnDDnDATInM All :;.66..........—A The ACORD name and logo are registered marks of ACORD vangilder September 1", 2010 Re: Enclosed Certificates Starting on 01 September 2010, the "Certificate of Liability Insurance" national template issued by ACORD changed. The certificate contains new cancellation notice language. Van Gilder, nor any other insurance agency, is no longer allowed to amend the certificate template. However, we understand how important notice of certain items is to you. Therefore, we are committed to providing the following: Should any of the policies identified on the enclosed certificates be cancelled or non -renewed, Van Gilder will endeavor to provide 30 days notice to you or that amount of notice coinciding with the notice Van Gilder receives from the insurance company. In the event of non-payment of premium, Van Gilder will endeavor to provide 10 days notice. Please note that failure to provide notice does not impose an obligation or liability on the Insurance company, or its agents, or representatives. Please do not hesitate to contact us with any questions or concerns Van Gilder Insurance Corp. Van Gilder insurance Corporation I PO Box 46510 1 Denver, CO 802Di I Tel 800.873.8500 1 Fax 303,831,5295 1 v vvgiacom