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109014 R.C. HEATH CONSTRUCTION CO - INSURANCE CERTIFICATE
Client8- 53255 HEASTI ACORD. CERTIFICATE OF LIABILITY INSURANCE D 1 0/voonrrr) 913Ma I30/2014 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 CONTANAME: Cindy Zimmerman Flood & Peterson Ins., Inc. PHONE 970-266-7155 Al 970-506.6845 A/C No Est: AIC No: P. D. BOX 576 E-MAIL ADDRESS: CZimmerman floodP eterson.com Greeley, CO 80632 970 356-0123 INSURERS) AFFORDING COVERAGE NAIC p INSURER A: Zurich American Ins. Co. 16535 INSURED INSURERS. Travelers Property Casualty Co 25674 R.C. Heath Construction Company Assurance 41190 PO Box 473 INSURER CPinnacol INSURER D: AGCS Marine Insurance Co. 22837 Fort Collins, CO 80522 INSURER 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 CONTRACTOR 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 ADOLSUBR INSR WVO POLICY NUMBER POLICY EFF MWDD/YYYY POLICY EXP W MWODIYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE A OCCUR X PD Ded: 5,000 X X CP0013704700 9/30/2014 09/30/2015 EACH OCCURRENCE $1 000000 PREMISES (EaTO s3000OO MED EXP (Any one person) $ 5 OOO PERSONAL B ADV INJURY $1000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY J( PRO- LOC PRODUCTS-COMPIOPAGG $2,000,000 $ A ANY AUTO' ALLOWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS X X CP0013704700 9/3012014 09/30/201 EO BINEDSINGLELIMIT1,000,000 JOMOBILELIABILITY BODILY INJURY(Per person) $ BODILY INJURY(Par accident) $ PROPERTY DAMAGE Per amidenI $ B UMBRELLA LIAR EXCESS LIAB Xd OCCUR CLAIMS -MADE ZUP41 M146401 9/30/2014 09/30/2011 EACH OCCURRENCE s6,000,000 AGGREGATE s6,000,000 DED I X RETENTION$10000 $ C WORKERS COMPENSATION ANO EMPLOYERS' LIABILITYER ANY PROPRIETOR/PARTNEWEXECUTIVE� OFFICERNMEMBER EXCLUDED? (Mandatory In NH) If yes, describe ender DESCRIPTION OF OPERATIONS below NIA X 4033691 10101/2014 10101/201 X WCsrATu- OTH- E.L. EACH ACCIDENT $1.000.000 E.L. DISEASE - EA EMPLOYEE $1000000 EL.DISEASE -POLICY LIMIT $1000000 D Blanket Builders Risk X X MX198471771 D9130120114 0913012015 $10,000,000 Any One Site/$1,000 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ANach ACORD 101, Additional Remarks Schedule, It more space Is required) RE: 7543 New Office Building at Nix Farm Natural Areas Certificate holder is included as Additional Insured as required by written contract with respects to general and automobile liability arising out of work performed by the named insured. City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Admin Services Purchasing Division ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 Fort Collins, CO 80522-0580 AUTHORIZED REPRESENTATIVE ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (20110/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S939279/M939192 Client#: 53255 HEASTI ACORD.TE CERTIFICATE OF LIABILITY INSURANCE O9/30/2014 YV) /30/2 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 Flood & Peterson Ins., Inc. P.O. Box 578 Greeley, CO 80632 970 356-0123 CONTACT Cindy Zimmerman PHONE 970-266-7155 FAX 970-506-6845 NC No Ex1: A/C No: E-MAIL CZimmermn@l1flqooPd eterson.com a ADDRESS: l_.•• INSURERIS) AFFORDING COVERAGE NAIC0 INSURER A: Zurich American Ins. Co. 16535 INSURED INSURER B: Travelers Property Casualty Co 25674 R.C. Heath Construction Company PO Box 473 INSURER CPinnacol Assurance 41190 INSURERD: AGCS Marine Insurance Co. 22837 Fort Collins, CO 80522 INSURER 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 CONTRACTOR 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. LTR TYPE OF INSURANCE NSRL SUBR MD POLICY NUMBER MM/DDY EFF MM/DDIYYsY)f LIMITS A GENERAL LIABILITY X X CP0013704700 9/3012014 09/30/201 EACH OCCURRENCE $1 OOO OOO PFEMIEES Ea E¢mrence $300000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR MED EXP(Any one person) $5000 PERSONAL SADV INJURY $1 OOO 000 X PD Ded: 5,000 GENERAL AGGREGATE s2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OPAGG $2,000,000 POLICY X PROJECT- 71 LOC $ A AUTOMOBILE LIABILITY X X CP0013704700 9/30/2014 09/30/2015 (Ea BINEDaccidentSINGLE LIMIT 1,000,000 X BODILY INJURY (Per person) $ ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED AUTOS X NON -OWNED AUTOS $ B )(UMBRELLA LIAR �XXJ OCCUR ZUP41M146401 9/30/2014 09130/2015 EACH OCCURRENCE s6000000 I AGGREGATE s6,000,000 EXCESS LIAR I CLAIMS -MADE DED I X RETENTION $10000 $ 1 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICEWMEMaER (Mndaory in NH)EXCLUDEO'! N/A X 4033691 10/01/2014 10101/2015 oTH- X WCSTATu- ER EL EACH ACCIDENT $1 OOOOOO E.L.DISEASE-EAEMPLOYEE EI OOOOOO If yes. descr ice under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1 OOO OOO D Blanket Builders X X MX198471771 9130/2014 09/3012015 $10,000,000 Any One Risk Site/$1,000 Deductible DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, AddlNonal Remanls Schedule, If more space Is required) Re: 7426 Transfort Maintenance Facility Expansion Project Certificate holder is included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named insured. City of Ft Collins PO BOx 580 Fort Collins, CO 80522 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 REPRESENTATIVE ACORD 25 (2010/05) 1 of 1 #S939291/M939192 ©1988.2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD