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Home My WebLink About485407 LANDTECH CONTRACTORS INC - INSURANCE CERTIFICATE (7)From Brooke Paulina FaxID:Forsbera Enaerman Date:9292014 2:26:28 PM Paae:2 of 2 LANDCON-01 BPAULING ,4CORo' CERTIFICATE OF LIABILITY INSURANCE DATE IM9/29/20142014YY) 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 Forsberg Engerman Co 3575 S Sherman St Englewood, CO 80113 NAMEACT Brooke Pauling PHONE 303 762-1717 FAI` 303 762-1733 ac Me ,,. ( ) (Fa. No : ( ) E-MAIL SS: brooke@forsberg-engerman.com INSURER(S) AFFORDING COVERAGE NAIC b INSURER A: Cincinnati Insurance Companies 10677 INSURED INSURERS : Pin nacol Assurance 41190 INSURER C: Westchester Surplus Lines Insurance Company 10172 Landtech Contractors Inc, Landtech Services LLC, Larry Overlay 525 N Laredo St INSURER D: INSURER E: - Aurora, CO 80011-9214 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 TYPE OF INSURANCE ADDL N D S B WAD POLICY NUMBER POLICY EFF MDDIYYYY MI POLICY EXP IYY MWODYY LIMBS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMSMADEOCCUR EPP 0173406 011012014 01101/2015 PREw SEs Ea occurrence $ 500,00 X MED EXP(Any one Person) $ 10,00 Contractual Liab PERSONAL B ADV INJURY S 1,000,00 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,00 POLICY �'EC' LOG PRODUCTS - COMPIOP AGO $ 2,000,00 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea.c brl S 1,000,00 X BODILY INJURY (Per Person) S A ANY AUTO EBA 0173406 01/012014 01/012015 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) S X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE JP.r accident S X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 8,000,00 AGGREGATE $ 8,000,00 A EXCESS LIAR CLAIMS -MADE EPP 0173406 01/012014 01/0112015 DED RETENTION$ $ IS WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIEroR/PARTNEFUEXEcu➢UE YIN OFFICERIMEMBER EXCLUDED? LJ (Mantlalory in NH) VSCR PTION OF OPERATIONS below NIA 2257602 10/012014 10/0112015 PER OTH- X STATUTE X ER E.L.EACHACCIDENT S 1,000,00 E.L. DISEASE -EA EMPLOYE $ 1,000,00 E.L. DISEASE -POLICY LIMIT $ 1,000,00 C Pollution Liability G24282624003 05/202014 05/20/2015 $1,000,0001 2,000,00 A Sched8: Stored/Leased EPP 0173406 01/012014 0110112015 Included/ 200,00 DESCRIPTION OFOPERATIONS ILOCATIONSIVEHICLES (ACOR0101, Adtlilional Remerka SCM1etlule, may be attached ll more spacebrepulrad) RE: 72D4 Veterans Plaza at Spring Canyon Community Park, Fort Collins CO. City of Fort Collins Purchasing Division 215 N Mason St 2nd Floor Fort Collins, CO 80522-0580 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 REPRESENTATPE I ACORD 25 (2014101) C 1988-2014 ACORD The ACORD name and logo are registered marks of ACORD reserved.