HomeMy WebLinkAboutKECI COLORADO INC - INSURANCE CERTIFICATEACORD. CERTIFICATE OF LIABILITY INSURANCE10/1,2014
TE
DA 2/2M7/2013
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(les) must be endorsed. If SUBROGATION IS WANED, 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 Lockton Companies, LLC Denver
8110 E Union Avenue
Suite 700
Denver CO 80237
(303)414-8000
CONTACT
RM FAX
INC, No Ere : INC. No ,
E-MAIL
INSURERS) AFFORDING COVERAGE
INSURER A: The Charter Oak Fire Insurance Company
NAIC 0
25615
INSURED K.E.C.I. Colorado, Inc.
1050899 5750 W. Airport Rd.
Sedalia, CO 80135
INSURER B: Travelers Prop. Casualty Co. of Am.
INSURER C : Pinnacol Assurance
INSURER E;
COVERAGES KECC CERTIFICATE NUMBER' 12439811 REVISION NUMBER: AAAAAAA
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.
IN&RI
TYPE OF INSURANCE
L
SUBR
POLICY NUMBER
POLICY EFF
I/l/2014
POLICY UP
I/I/2015
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE E OCCUR
7 Limited Jobsite
Y
N
DTC06C647481
EACH OCCURRENCE
1000000
PAMAGE
S ( RED D
300,000
MED UP (Any one person
5,000
PERSONAL a ADV INJURY
$ 1,000,000
Pollution
GENERAL AGGREGATE
it 2 000 000
GENL AGGREGATE
PQLICYI
LIMIT APPLIES PER.
X IPRO
PRODUCTS- COMPIOP AGO
$ 2,000,000
$
B
AUTOMOBILE LIABILITY
ANY AUTO
AUTOS EDNSCYSrUED
NOgpWNED
HIRED AUTO $ AUTOS(Per
Ix
Y
N
DT810325D9148
I/1/2014
I/I/2015
MBCM� SINGLE LIMIT
$ 1000000
BODILY INJURY (Per peraon)
$ j{)(J(J()M
BODILY INJURY (Per acckent
$ } Yyy,)()(J(
PROPERTY DAMAGE
aocKientl
$ X .r
aXXXXXXX
B
X
UMBRELLA LIAO
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
N
N
DTSMCUP325D9148
1/l/2014
I/l/2015
EACH OCCURRENCE
s 5000000
AGGREGATE
$ 5,000,000
DED I x I RETENTION$10,000
$ XXYVVM
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOWPARTNERIEXECUTIVE
OY^CeE�Rry 1. NH) FJtCLUOEDY N❑
DESCRIPTION OF OPERATIONS Celow
NIA
N
4048534
IUII/2013
10/I/2014
T
X T RY LIMR FR
EL EACH ACCIDENT
$ 500000
EL. DISEASE-EAEMPLOYEE
Is 500000
E.L. DISEASE -POLICY LIMIT
Is SOO UOO
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I(AHach ACORD 101, Additional Remarks Schedule, R mare space is required)
RE: 7519 Lemay Ave Bridge Expansion Joint. The City, its officers, agents and employees are additional insured as respects General and Auto Liability if
required by written contract per policy terms and conditions. Ten(10) Day Notice of Cancellation will be provided to the City for non-payment.
12439811
City of Fort Collins
Purchasing Department
PO Box 280
Ft Collins CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WALL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
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