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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. rh. nrnwn ...... ann Innn All