The URL can be used to link to this page

Home My WebLink AboutLEFT HAND EXCAVATING - INSURANCE CERTIFICATE (6)Client#: 53412 8LEFTHAN1 ACORD,,CERTIFICATE OF LIABILITY INSURANCE DATE Otl03123/20I014 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(les) 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 " ACT N ME: Willis of Colorado, Inc. a2" o, 303 722-7776 uc pip: 303-722$862 2000 South Colorado Boulevard E-MAIL Tower 11, Suite 900 ADDRESS: INSURER(S) AFFORDING COVERAGE NAM Is Denver, CO 80222 INSURERA: CIBE Insurance Corp 39217 INSURED INSURER B: PinnaCol Assurance 41190 Left Hand Excavating INSURERC: Atlantic Specialty Insurance 27154 7733 N 73rd Street 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 BY PAID CLAIMS. LTR TYPE OF INSURANCE 'NODE SMU0IB POLICY NUMBER ppRppE 1DICCUCED MMICDYE F MMID y LIMITS A GENERAL LIABILITY CC11174022 111117120113 1111712014 $1000000 X COMMERCIAL GENERAL LIABILITY pEpgAqICL�1H ��OEEC7C7UR��RENCE PREMISESEaomurrence $100000 CLAIMS -MADE a OCCUR MED EXP (Any oneperson) $10 000 PERSONAL& ADV INJURY $1000000 X PDDed:1,000 X Al #CG 8156 03 09 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $2,000,000 POLICY X jRO- LOC aCT $ A AUTOMOBILE LIABILITY CBA1174020 1/17/2013 11117/2014 EB e�tlEDISINGLE LIMIT 1,000,000 BODILY INJURY (Per person) X ANY AUTO $ ALL OWNED SCHEDULED AUTOS AUTOS X HIRED AUTOS X NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ A UMBRELLA LIAB X OCCUR CCU1174021 111171201311117/201 EACH OCCURRENCE $1000000 )( AGGREGATE $1 000 000 EXCESS LIAB I CLAIMS-MADE DED I X RETENTION $0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE Y/ N OFFICER/MEMBER EXCLUDED? (Mandatory In NH) NIA 1663960 1/01/2014 01l01/204 X T STATU- OTH- E.L. EACH ACCIDENT $500000 E.L. DISEASE - FA EMPLOYEE $500000 E.L. DISEASE- POLICY LIMIT $500 000 If yes, descnhe under DESCRIPTION OF OPERATIONS below C Installation 7900067540005 11117/2013 11117/201 $250,000 Per Project Floater 50,000 Temp Storg&Trans $1,000 Deductible DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more space Is required) 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 #S1080527/M1080506 (G) 19BR-2010 ACORD CORPORATION- All riehts reserved 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 #510805271M1080506 COMMERCIAL GENERAL LIABILITY CG 81 56 03 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES, CUSTOMERS OR CONTRACTOR'S - COMPLETED OPERATIONS - 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 11 — 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 work" performed for that additional insured, and 2. included in the "products -completed oper- ations hazard B. Additional Conditions 1. The written contract or written agreement must be: a. Currently in effect or becoming effective during the term of this policy; 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. Includes copyrighted material of Insurance Services Office, Inc. CG 81 56 03 09 with its permission. Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: 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. D. As respects the coverage provided by this endorsement, Paragraph 4.a. Section IV Commercial General Liability is deleted and replaced by: 4. Otherinsurance a. This insurance is primary except when b. below 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 c. 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 8156 03 09