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Home My WebLink AboutARCHER WESTERN CONTRACTORS LLC - INSURANCE CERTIFICATE (3)-1 • A�Ro CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) D62DQD,4 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) most 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 Aon Risk $erV1Ce5 Central, Inc' Chicago IL office CONTACT NAME: PHOrE FAx 800-363-0105 (AIC,EAt): (866) 283-7122 NC. No.: 200 East Randolph Chicago IL 60601 USA E-MAL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED WSURER A Allied World National Assurance company 10690 Archer Western Contractors. LLC 1411 Greenway Drive Irving Tx 75038 USA INSURER B: Arch Insurance Company 11150 INSURER C: NSURER D: em R E. INSURER F: COVERAGES CERTIFICATE NUMBER: 570053801773 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. Limits shown are as requested INSIR _LA TYPE OF INSURANCE INSD VND POLICY NUMBER MMIODIYYYY MMIDDIYYYY LIMITS B % COMMERCIAL GENERAL LIABILITY 41PKG89U19U6 Ub/UI/ZU14 EACH OCCURRENCE $1,000,000 CLAIMS -SLIDE %❑ OCCUR PREMISES Ea oo`u nce $300,000 Penan) UP (Any one pon) $25,000 PERSONAL d ADV INJURY S1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY [�] PRO- F_X] LOC JECT PRODUCTS-COMPIOP AGG S2,000,000 OTHER: B AUTOMOBILE LIABILITY 41PKG8901908 AOS 06/01/201406/01/2015 COMBINED SINGLE LIMB Ea - t S2,000,000 BODILY INJURY( Per person) B ANY AUTO 41CAB8902008 06/01/2014 06/01/2015 ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS N MA ONLY BODILY INJURY (Per adaaent) PROPERTYDAMAGE Peram0enl A UMBRELLA LIM X OCCUR 03056149 06/01/2014 06/01/2015 EACH OCCURRENCE S10,000,000 % EXCESS LIB CLAIMS -MADE AGGREGATE $10,000,000 DED1 IRETENTION B WORKERS COMPENSATION AND EMPLOYERS'UABILITY YIN My PROPRIETOR/PARTNERIEXECURVE OFF CER/MEMBER EXCLUDED, N (Mandatory in NH) N/A 41WC18901708 O1/01/2014 06/01/2015 PER OTH- X STgTUTE E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 Iry deepdba.mmr DESCRIPTION OF OPERATIONS below E L. DISEASE -POLICY LIMIT S1, 000, 006 e Misc Liab Cvg 41GPP9902108 06/Ol/2014 06/01/2015 Each GOO urrence — 11,000,000 Excess General Liability Aggregate $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additlonal Ranuda Schedule, may be aHaclnd B more space Is required) RE: Water/Wastewater Treatment Design/Construction Contractor RFP #7220. See attached. CERTIFICATE HOLDER CANCELLATION 0 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, Colorado AUTHORIZED REPRESENTATIVE 4316 LaPorte Avenue ' Fort Collins CO 80522 USA Jqem i I '1 91988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 10774508 LOC #: ® ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk services Central, Inc. NAMEDINSURED Archer western Contractors, LLC POLICY NUMBER see certificate Number: 570053801773 CARRIER see certificate Number: 570053801773 NAIC CODE EFFECTIVE DATE. ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Attachment with Respect to RFP #7220, city of Fort Collins, Colorado is an Additional insured pertaining to General Liability with respects to liability arising out of the Named Insured's operations on the referenced project. Professional services for Architects, Engineers, consultants, etc, are excluded. completed Operations is included, subject to the terms, conditions, limitations and exclusions of the General Liability policy. The General Liability policy includes the perils of (xcu) Explosion, Collapse and underground. The ACORD name and logo are registered marks or ACORD