HomeMy WebLinkAbout524763 JUB ENGINEERS INC - INSURANCE CERTIFICATEJUBEN-1 OP ID: JY
T
,acoR�" CERTIFICATE OF LIABILITY INSURANCE
O0810ATE 8 /2014Y)
os/os/zola_ .
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 'term s 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 .-
PR000C_ER.,. ,Ci y....
. _. .. _..
The HartxBILCOrporatlon 'Cal-T', ..... _........ - - - -. -. ,.- ... - ..
PO BOX'400 ,, .,.�.,' •• '
Caldwell,.ID.83606 "'_'' _ _'''`'
_ .. j
Jeremy Kroll -- -
- -
-...
CONTACT .. .. ...
NAME:
.PHONE - _.... - .... - . A '.1 •.
_._. - ___ AIC No.^ - _
A/C NO E.
E-MAIL . _....
ADDRESS:
-
INSURERS AFFORDING COVERAGE - - -
— NAIC p
INSURER A:Travelers Indemnity of CT
25682
INSURED J-U-B Engineers, Inc.
INSURER B:Travelers Casualty and Surety
31194
250 S Beechwood Ave, Suite 201
Boise, ID 83709
INSURER c:XL Specialty Insurance Co.
37885
NsuRERD:Travelerslndemni Co of Am.
25658
INSURER E
INSURER F :
^=error A ry Llumem. RPVISInM NI IMRPR-
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.
IinNSR
LTRIbM&
TYPE OF INSURANCE
SUER
JMMPOLICY
NUMBER
MM/DDADOL
T
CY UP
MMIDD/YYYY
LIMITS
GENERAL LIABILITY
WE
$ 1,000,00
TO RENTEIT—
PREMISES fEa occurrence
It 1r000,00
A
X COMMERCIAL GENERAL LIABILITY
X
X
MED UP (Any one person)
f 10,00
CLAIMS -MADE O OCCUR
PERSONAL$ ADV INJURY
It _1,000,00
X CGD381
6807769N196
08/01/2014
08/01/2015
GENERAL AGGREGATE
It -- 2,000,00
.. .,
r
-
GEN'L'AGGREGATE LIMIT APPLIES PER'.
'PRODUCTS=COMP/OP AGG'
f-- -2,600,00
POLICY.FX ,PRO LOC
EC
=.L
"AUTOMOBILE LIABILITY
••`-
-- — - -
---
COMBINED SINGLE LIMB _ _
Ea accitlent
_ _ 1,000,00
BODILY INJURY (Per person).-
D:-
X. ANVAUTo ""
X
�k-.
B47770068 -
08/01/2014
08101/2015
BODILY INJURY (Per accident)
f -
ALLOV SCHEDULED
-
AUTOS' ' AUTOS
NON -OWNED
_ -
PROPERTY DAMAGE
PER ACCIDENT
$
HIRED AUTOS AUTOS
- -
It
X CAT353
UMBRELLA LWB
OCCUR
EACH OCCURRENCE
$
H
AGGREGATE
$
EXCESS LIAR
CLAIMS -MADE
DIED RETENTION f
$
WORKERS COMPENSATION
WC SLIM OTH-
La-
B
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVEY�
OFFICE(MandaR/MEM E%CLUDED'!
NIA
UB054OT503
08/01/2014
0810112015
E.L. EACH ACCIDENT
$ 1,000,00
NHI
(Mandatory in NH)
ASTOP GAP
E.L. DISEASE - EAEMPLOYEE
$ 1,000,00
E.L. DISEASE -POLICY LIMIT
�..
"S - ^1iODO:DD
If yes, describe uMea_-. _ -
DESCRIPTION OF OPERATIONS below
C
Profes Liability
DPR9713670
04/02/2014
04/02/2016
Ea Claim 6,000,00
$200,000 deductibl
INCL POLLUTION
Annl Aggr 6,000,00
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 707, Additional Remarks Schedule, If more apace is required)
7525 Arthur Ditch Bridge Replacement Design Services
Ten days' direct notice of cancellation to City of Fort Collins is endorsed
onto insurance policies shown on this Certificate.
City of Fort Collins Colorado is additional insured for auto end general
liability as provided by policy forms CGD381 and CAT353.
City of Fort Collins
Attn: Purchasing Dept
PO Box 580
Fort Collins, CO 80522-0580
FORTC-1
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED1 REEP,RE�SEENTATIVE
cv T1�k
ACORD 26 (2010105)
01988.2010 ACORD
The ACORD name and logo are registered marks of ACORD
reserved.