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Home My WebLink About113060 MOUNTAIN CONSTRUCTORS INC - INSURANCE CERTIFICATE (6)Page 1 of 1 ,�►Cil CERTIFICATE OF LIABILITY INSURANCE ��. DA07/25TE /2014 o7/z5/2o14 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 Willie of Colorado, Inc. c/o 26 Century Blvd CONTACT NAME: PAICHONE EX ;1-877-945-7378 q/C No 1-888-467-2378 E-MAIL ADDRESS: certificates@willis.com P.O. Box 305191 Nashville, TN 372305191 USA INSURERS AFFORDING COVERAGE NAIC P INSURER A: Charter Oak Fire Insurance Company 25615 INSURE94ountain Constructors, Inc. INSURER B: Travelers Property Casualty Company of Asiatic 25674 INSURER C: pinnacol Assurance Company 41190 622 Main Street PO Sox 405 Platteville, CO 80651 INSURER D: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: W502632 REVISION NUMRER- 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. INSR LTR TYPE OF INSURAINCE ADDLSJUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FZ;71 PD Dad. $1,000 y DT-CO-325D6251-COF-14 07/28/2014 07/28/2015 AMA E PREMISES Ea occurrence E 300,000 MED EXP(Anyone person) $ 5,000 PERSONAL S ACV INJURY $ 1,000,000 GENERAL AGGREGATE- $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ 2,000,000 POLICY -X PRO- LOC S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accitlent 1,000,000 BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS y DT-830-3918A004-TIL-14 07/28/2014 07/28/2015 BODILY INJURY Per accident $ MIRED AUTOS NON -OWNED AUTOS - PROPERTY DAMAGE Perarzmant $ $ 9 X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 !ICE !B CLAIMS -MADE DTSM-CUP-391BA004-TIL-14 07/28/2014 07/28/2015 DED XLUIRETENTION$10,000 g C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNEWEXECUTIVE OFFICERIMEMBER EXCLUDED'! N/A 3027994 07/01/2014 07/01/2015 x WC STATU- OTH- E.L. EACH ACCIDENT $ 1,000,000 ' E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory In Will I(yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 B seed/Panted Equipment DT-660-5059A618-TIL-14 07/28/2014 07/28/2015 250,000; $1,DDO Scheduled Equipment RCV less $1,000 Deductible DESCRIPTION OF OPERATIONS LOCATIONS / VEHICLES (Attach ACORD tot. Additional Remarks Schedule, If more space Is required) P..J.CG 7557 West Prospect Road Bridge Replacement at New Herne. Ditch. - rort Collins, the Colorado Departmant of Transportation, and the New Mercer Ditch Company are named as Additional Insured. as respects to General Liability and Auto Liability. 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 REPRESENTATNE City of Fort Collins 300 Laporte Ave. Fort Collins. CO 805: CORPORATION. All rights ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD SA ID:6348310 BATCH:Batch 4: 76113