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HomeMy WebLinkAbout287763 TRAUTMAN & SHREVE INC - INSURANCE CERTIFICATE (3)e CERTIFICATE OF LIABILITY INSURANCE ACORU091200 III DIDD YYYY) ATE (MM 09120I2014 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 endorsement(s). PRODUCER MARSH USA, INC. 501 MERRITT 7 NORWALK, CT 06856 Attn: Emcor.Cemequesl@marsh can I Fax: 203-22M787 CONTACT NAME: PHONE FAX INC No EXII, ac No: E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC $ INSURER A: Continental Casually Company 20443 888715-EMC-TRA-14-15 INSURED f� C-/� `1 (,r TRAUTMAN 8 SHREVE, INC. (/1\ 11�1 \ U.j. 4406 RACE STREET INSURER B: American Casualty Company Of Reading, Pa 20427 INSURER SP Tran oW6m Insurance Co 20494 INSURER D DENVER, CO 60216 INSURER E INSURER F : rn%'Monncc f PPTIFIr.ATF NIIMRFR- NYC-005873095-33 REVISION NUMBER:2 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 INSURANCE A L UBR POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDDIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE M OCCUR GL 4025755651 10101 014 10101/2015 EACH OCCURRENCE $ 2,000,000 AMA E T RENTED PREMISE Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 25,000 PERSONAL a ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 6,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES PER: X PRO- LOG PRODUCTS - COMP/OP AGG $ 14,000,000 $ A AUTOMOBILE LIABILRY X ANY AUTO ALL OWNED f I SCHEDULED AUTOS OS NON -OWNED X HIRED AUTOS X AUTOS BUA 4025755696 10/01/2014 10101/2015 COMBINED SINGLE LIMIT Ea accident 2,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per aocidem) $ PROPERTY DAMAGE Per accident $ Auto Physical Damage $ Induced A X UMBRELLA I-MB EXCESS LIAB X OCCUR CLAIMS -MADE L 2068208285 10101/2014 1010112015 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED I X I RETENTION$ 10,000 $ B B C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR/PARTNEREX� OFFICERIMEM ER EXCLUDED? ECUTIVE - (Man"ot, In NH) 8 yes. describe under DESCRIPTION OF OPERATIONS below NIA WC 4025755584(ADS) WC 4025755598 (CA) WC 4025755570 (AZ, OR, WI) 10/01/2014 I20 1010114 10/01/2014 10/01/2015 10/0112015 10/01/2015 X I WC STATU- OTH- E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT I $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ANach ACORD 101, AddlUonal Remarks Schedute, if move space Is required) Re: all operations. Additional insureds under all policies (except Workers' Comp) where required by contract: City of Fort Collins. rcorlcrr ATE HOLDER CANCFI I ATION City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 300 Laporte Avenue THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Fat Collins, CO 80524 ACCORDANCE WITH THE POLICY PROVISIONS - AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Heidi Bauermeister —'ilirezaei �i .90AV-1/Zr/6aSL!>'� ©1988-2010 ACORD CORPORATION. All rights reserveci. ACORD 26 (2010105) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 888715 LOC #: Norwalk Ac R e ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY MARSH USA, INC. NAMED INSURED TRAUTMAN & SHREVE, INC. 4406 RACE STREET DENVER, CO BU16 POnCY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certfficate of Liability Insurance Auto Physical Damage Comp / Coll Deductible $500 In the event of cancellation or material change that reduces or restricts the insurance afforded by this Coverage Part (other than the reduction of aggregate limits through payment of claims as applicable), Insurer agrees to mail prior written notice of cancellation or material change to: Certificate Holder Schedule 1. Number of days advance notice: For any statutorily permitted reason other than non-payment of premium, the number of days required for notice of cancellation as provided in paragraph 2 of either the Cancellation Common Policy Conditions or as amended by the applicable state cancellation endorsement is increased to the lesser of 60 days or the number of days required in a written contract. For nonpayment of premium, The greater of (1) the number of days required by state law or (2) the number of days required by written contract. 2. Name: Notice will be mailed to: Cedificate holder ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD® CERTIFICATE OF LIABILITY INSURANCE `�. MMVD °A�'091ZO0I2014 "" 014 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: N 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 MARSH USA, INC. 501 MERRITT 7 CONTACT NAME: PHONE No): E-MAIL ADDRESS: NORWALK, CT 06856 Attn: Emcor.Certrequest@marsh.win 1 Fax: 203-229-6787 INSURERS AFFORDING COVERAGE NAIC If 888715-EMC-TRA-14-15 ABCDE 21318 X INSURER A: Continental Casualty Company 20443 INSURED TRAINSURER 4406 406 RACE 8 SHREVE, INC. E RGE STREET B: American Casually Company QI Reading, Pa 20427 INSURER c : Transportation Insurance CO 20494 INSURER D : DENVER, CO 80216 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: NYC-006620083-08 REVISION NUMBER:3 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 INSURANCE ADDL UBR POLICY NUMBER MWOUIYYEYFYFY MMIODIYYYY UNITS A GENERAL LIABILITY GL 4025755651 1010112014 10/0112015 EACH OCCURRENCE $ 2,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 111 OCCUR -DWA T RENTED PREMISES Ea occurrence $ 1,000,000 MED E%P (Any one person) $ 25,000 PERSONAL S ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 6,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG $ 14,000,OW $ POLICY rX1 PRO- LOC A AUTOMOBILE LIABILITY BUA 4025755696 1010112014 10/01/2015 COMBINED SINGLE LIMIT Ea accident 2.000,000 BODILY INJURY (Per person) $ ANY AUTO XIHIRED ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTYDAMAGE Peraccldent $ X X NON-OVMED AUTOS AUTOS Auto Physical Damage $ Induded A X UMBRELLA UAB OCCUR L 2068208285 10/01/2014 10101/2015 EACH OCCURRENCE $ 5,0W.000 [I AGGREGATE $ 5,000,000 EXCESS UAB CLAIMS -MADE DED I X I RETENTION$ 10,000 $ B WORKERSCOMPENSATION VIC4025755584 (ADS) 10/0112014 1010112015 X I WCSTATU- oTH- B C AND EMPLOYERS' LIABILITYER ANY PROPRIETORIPARTNER XECUTIVE YIN OFFIOEMEEXCLUDED?❑N LLNMI (Mandatory Inn BER Exuoeo? NIA WC 4025755598 (CA) 7 WC 402575550 AZ, OR, WI ( ) 10101I2014 10/01/2014 1010112015 10101/2015 E.L. EACH ACCIDENT $ 1,000,000 E L. DISEASE -EA EMPLOYEE 4 1,000,000 U yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, R more space Is required) RE: JOB NO. 21318-107 - POUDRE VALLEY HEALTH SYSTEM BUILDING A DEMO ADDITIONAL INSURED UNDER ALL POLICIES (EXCEPT WORKERS COMPENSATION 8 EMPLOYERS LIABILITY) WHERE REQUIRED BY CONTHAC T: THE INDEMNITEES COVERAGE PROVIDED TO THE ADDITIONAL INSUREDS IS PRIMARY 8 NON-CONTRIBUTORY. WAIVER OF SUBROGATION AS REQUIRED BY CONTRACT. CONTRACTUAL LIABILITY COVERAGE IS INCLUDED. UMBRELLA POLICY SITS ABOVE THE UNDERLYING GENERAL LIABILITY, EMPLOYERS' LIABILITY AND AUTO LIABILITY. THE GENERAL LIABILITY POLICY HAS NO XCU EXCLUSION. CITY OF FORT COLLINS 300 LAPORTE AVE. 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. AUTHORU:ED REPRESENTATIVE of Marsh USA Inc. Heidi Bauermeisler ca— 404/0� 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 888715 LOC #: Norwalk AGENCY MARSH USA, INC. POLICY NUMBER CARRIER ADDITIONAL REMARKS SCHEDULE Page 2 of 2 NAIC CODE THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insui Auto Physical Damage Comp I Coll Deductible $500 NAMED INSURED TRAUTMAN 8 SHREVE, INC. 4406 RACE STREET DENVER, CO 80216 EFFECTIVE DATE: In the event of cancellation or material change that reduces or restricts the insurance afforded by this Coverage Part (other than the reduction of aggregate limits through payment of claims as applicable), Insurer agrees to mail prior written notice of cancellation or material change to: Certificate Holder Schedule 1. Number of days advance notice: For any statutorily permitted reason other than non-payment of premium, the number of days required for notice of cancellation as provided in paragraph 2 of either the Cancellation. Common Policy Conditions or as amended by the applicable stale cancellation endorsement is increased to the lesser of 60 days or the number of days required in a written contract. For non-payment of premium, The greater of (1) the number of days required by state law or (2) the number of days required by written contract. 2. Name'. Notice will be mailed to: Certificate holder rannamil C 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD