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Home My WebLink About150588 WALSH CONSTRUCTION INC - INSURANCE CERTIFICATE (17)OP ID: TA ,A`o�zo CERTIFICATE OF LIABILITY INSURANCE DATE03/030lYYYY) 3/03/14 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 endorsements . PRODUCER 970-223-1804 Front Range Insurance Group 1100 Haxton Drive Suite 100 Fort Collins, CO 80525 David A. Wooldridge LUTCFAAI CONTACT NAME: PHONE FAX ac No Earn, ac No): E-MAIL ADDRESS:PRODUCER CUSTOMERID . WALSH-4 INSURE S AFFORDING COVERAGE NAIL$ INSURED Walsh Construction, Inc. c Matthew Walsh, Pres. i5 Og 8139 Open View Place Loveland, CO 80537 INSURER A: Pinnacol Assurance 41190 INSURERS: Builders Insurance Group INSURER c:Travelers 25682 INSURER D : Acuity 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 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. LTR TYPE OF INSURANCE POLICY NUMBER IMMIDDNYYY1 I IMM/DDffYYY)LIMITS B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR X PKGO104291-03 06/01/13 06/01/14 EACH OCCURRENCE $ 1,000,00 PREMISES(Ea occu anca, $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL$ ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEML AGGREGATE LIMIT APPLIES PER: 17 POLICY X PRO- LOG PRODUCTS-COMP/OP AGG $ 2,000,00 $ D AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X74154 X74154 X74154 X74154 07l03113 07/03/13 07/03/13 07103114 07/03/14 07/03/14 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X E E B X UMBRELLA LUIB EXCESS LIAB AlOCCUR CLAIM94AADE UMB011984902 06/01/13 06/01114 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ DEDUCTIBLE RETENTION $ 10,000 $ rxi IS A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORMARTNEWEXECUTIVE r- OFFICERIMEMBER EXCLUDED? (MandatoryinNH) R as, describe under DESCRIPTION OF OPERATIONS below N/A 104361 05101113 05101/14 INC STATU- X E.L. EACH ACCIDENT ----- $ 1,ODD,OO E.L. DISEASE - EA EMPLOYEE ---- - $ 1,000,00 I E.L. DISEASE -POLICY LIMIT $ 1,000,00 C Contractors Equip 660-366M100A 06/01/13 06/01114 Sch Equip 174,20 Leas/Rent 100,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more space is required) City of Ft. Collins is listed as an Additional Insured with regards to the General Liability policy. CERTIFICATE HOLDER CANCELLATION CITYOFF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of Fort CollinsACCORDANCE WITH THE POLICY PROVISIONS. Attn: Purchasing P.O. Box 580 Fort Collins, CO 80522 AUTHORMED REPRESENTATIVE 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD OP ID: TA A �R� CERTIFICATE OF LIABILITY INSURANCE oAT03/03114YYI 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). PRODUCERNAME 970-223-1804 Front Range Insurance Group 1100 Haxton Drive Suite 100 Fort Collins, CO 80525 David A. Wooldridge LUTCFAAI CONTACT PHONE FAX A/c No Eat: MC,No: E-MAIL ADDRESS: PRODUCER WALSH� C T ER 10 e: INSURE S AFFORDING COVERAGE NAK:$ INSURED Walsh Construction, Inc. Matthew Walsh, Pres. 8139Open View Place Loveland, CO 80537 INSURER A: Pinnacol Assurance 41190 INSURERS: Builders Insurance Group INSURER C: Travelers 25682 INSURER D : Acuity 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 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. LTa TYPE OF INSURANCE ADDL BUSH POLICY NUMBER MMIDD�Y MwWDDAIM LIMITS B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I OCCUR X PKGO104291-03 06/01/13 06/01/14 EACH OCCURRENCE $ 1,000,00 PREMISES Eaomurreoce $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL S ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEML AGGREGATE LIMIT APPLIES PER: POLICY FX7 PRO- LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ D AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X X74154 X74154 X74154 X74154 07/03/13 07/03/13 07/03/13 07103/14 07103/14 07103/14 COMBINED SINGLE LIMIT $ 1,000,00 X BODILY INJURY (Per person) BODILY INJURY $ X BODILY INJURY (Par accident) $ PROPERTYDAMAGE (Per accident) $ X X $ $ B X UMBRELLA LIAS EXCESS LIAR X OCCUR CLAIMS -MADE UME1011984902 06/01/13 06/01/14 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ DEDUCTIBLE I RETENTION $ 10,000 $ X $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPMETORIPARTNER/EXECUTIVE Y OFFICERIMEMBER EXCLUDED? (Mandatory In NH) Byes, describe under DESCRIPTION OF OPERATIONS below NIA X 4104361 06/0t/13 05/01/14 WC STATU- LIMITS IX OTH- E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE- POLICY LIMIT $ 1,000, 00( C Contractors Equip 660-366M100A 06/01/13 06101/14 Sch Equip 174,2 Leas/Rent 100,0 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remark. Schedule, If more space is required) As respects the City of Fort Collins State of Colorado, M.A. Mortenson Company and Woodward Inc, subcontractor's operations on this project, the Cityy of Fort Collins State of Colorado, M. A. Mortenson Company and oodward Inc are included as additional Insureds under the General Liability, CITYFC2 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 1933.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD No Text OP ID: TA �c`oRo CERTIFICATE OF LIABILITY INSURANCE DATE 03/03/ 4YY) 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 Front Range Insurance Group 1100 Haxton Drive Suite 100 Fort Collins, CO 80525 David A. Wooldridge LUTCFAAI INSURED Walsh Construction, Inc. INSURER A: Pirmacol Assurance 41190 Matthew Walsh, Pres. INSURER B: Builders Insurance Group 8139 Open View Place INSURER C: Travelers 25682 Loveland, CO 80537 INSURER D : Acuity 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 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. INTR TYPE OF INSURANCE POLICY NUMBER U Y FF MMIDDIYYYY POLICY EXP MM/DD/YYYY UMn8 GENERAL LIABILITY CURRENCE $ 1,000,00 S (Ea an.) $ 100,00 B X COMMERCIAL GENERAL LIABILITY X PKGO104291-03 06/01/13 06/01/14 (Anyon.pemon) $ 6,0 00 CLAIMS -MADE OCCUR AL B ADV INJURY 7GENNERAL $ 1,000,00 AGGREGATE $ 2,000,00( GEN'L AGGREGATE LIMIT APPLIES PER: TS-COMP/OP AGG $ 2,000,00 $ POLICY X PRO- LOG D AUTOMOBILE X LIABILITY ANY AUTO X74154 07/03113 07/03/14 COMBINED SINGLE LIMIT (Ea $ 1,000,00 ILalone) BODILY INJURY (Per X ALL OWNED AUTOS X74154 accedeperson) BODILY INJURY (Per accident) $ S X PROPERTY DAMAGE (Peraccidsnt) $� SCHEDULED AUTOS HIRED AUTOS X74154 07/03/13 07/03/14 X $ NON -OWNED AUTOS X74154 07/03/13 07/03M4 X UMBRELLALUIB X OCCUR EACH OCCURRENCE S 1,000,00 AGGREGATE $ B EXCESS UAB CLAIMS -MADE UM6011984902 06/01/13 O6I01114 DEDUCTIBLE $ X $ RETENTION $ 10,000 A WORKERS COMPENSATION EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVEY� OFRCERIMEMBER EXCLUOEO4 (Mandatory In NH) NIA 4104361 05/01/13 05/01/14 WC STATU- l I X DEN T Y E.L. EACH ACCIDENT S 11000100 E.L. DISEASE - EA EMPLOYEE S 1,000,00 IE.L. DISEASE -POLICY LIMIT S 1,000,00 If yes, describe under DESCRIPTION OF OPERATIONS below C Contractors Equip 660.366MI00A 06101/13 06/01/14 Sch Equip 174,20 Leas/Rent 100,00 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if mom space Is required) City of Fort Collins is covered as additional insured under the general liablity policy. Project: 7506 Spring Creek Trail Connection - Centre Ave to Mason Trail CERTIFICATE HOLDER CANCELLATION CITYFO5 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Fort Collins Purchasing Division 215 North Mason Street Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD