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Home My WebLink AboutE-Z EXCAVATING INC - INSURANCE CERTIFICATEEZEXC-1 OF ID: MMZ ,4coR0" CERTIFICATE OF LIABILITY INSURANCE YYYJ D0612 712 Y014 6/24 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 terns 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 CRS/Surescape Ins. Services 6600 E. Hampden Ave. Denver, CO 80224 Erik E. Ulibarri CCONTACT Erik E. Ulibarri PHONE nlX No): A/c No E,):303-996-7801 no ess: rburgess@crsdenver.com INSURERS AFFORDING COVERAGE NAIC d INSURERA: Westfield Insurance 24112 INSURED E-Z Excavating, Inc. INSURERB: United Speciality Insurance Co P.O. Box 1439 Longmont, CO 80502 INSURERC: Navl gators Insurance Co. INSURER D: Pinnacol Assurance NSURER 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 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 OF INSURANCE L ADDTYPE UB POLICY NUMBER EFF MD/YYYY IODPOLICY/YYYY MM/D POLICY EXP LIMITS B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE F7X OCCUR X BT0141676 07I01I2014 07I0112015 PREMISES Ea occurrence S 50,00 MED EXP(Any one Person) $ EXCLUDE X PD Ded: $5,000 PERSONAL SADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY X PRO- JECT LOC PRODUCTS -COMP/OP AGO $ 2,000,00 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT EaecodeM $ 1,000,00 X BODILY INJURY (Per person) $ A ANY AUTO CMM1614596 07/01/2014 07/01/2015 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X NON -OWNED HIREDAUTOS AUTOS X PROPERTYDAMAGE Perarddent $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,00 X AGGREGATE $ 10,000,00 C EXCESS LIAB CLAIMS -MADE GA14EXC6210151C 07/01/2014 07/01/2015 DED I X I RETENTION$ 0 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMSER EXCLUDED? (Mandatory in NH) dyes describe under DESCRIPTION OF OPERATIONS be. N / A 4058319 07/01/2014 07/01/2015 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E. L. DISEASE - POLICY LIMIT $ 11000100 A Lease/Rented Equip CMM1614596 07/0112014 07/01/2015 Limit 600,00 Special FOrrl/ACV Ded 1,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, ACdiOonal Ramrlrs Sdhoduls, may W Attached 11 more spade Is required) Certificate holder is included as additional insured on the General Liability with respect to ongoing operations of the named insured for the certificate holder as required by written contract. All policy terms, conditions and exclusions apply. CITYFTC City of Fort Collins 300 LaPorte Avenue Fort Collins, CO 80521 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORRED REPRESENTATIVE Q qt ®1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD