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Home My WebLink About463826 TATONKA CONTRACTORS LLC - INSURANCE CERTIFICATE (5)A`� �® CERTIFICATE OF LIABILITY INSURANCE 9/25/20 "' 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 - Keller Lowry Insurance 1777 S Harrison St #700 Denver CO 80210 CO NA ffT TBIBs8 Hellpel PHONE (303)756-9909 FAX AIC,No. (303)756-8815 EApm�AIgLss.icashelp@kellerlowry.com INSURERS AFFORDING COVERAGE NAIC tl INSURERA:Cincinnati Insurance 10677 INSURED Tatonka Contractors, LTD. 14555 Quail Run Road Hudson CO 80642 INSURER B INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:14-15 GL,UM 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 ANYCONTRACTOR 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 ADUL SUUH POLICY NUMBER POLICY EFF I%IM/DDJYYYY1 POLICY EXP OJNUD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 DAMAGEIORENIED PREMISES Me omygerwel $ 500,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X ENP0162799 10/20/2014 10/20/2015 MED EXP (Any oneperson) $ 10,000 PERSONAL SADV INJURY $ 1,000,000 X ADDITIONAL INSURED GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,000 - X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGL LIMIT Ea acc dem - BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Pe ids $ NON -OWNED HIRED AUTOS AUTOS $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 11000,000 AGGREGATE $ 11000,000 A EXCESS LIAB CLAIMS -MADE DEO X RETENTION$ 10,00 $ ENP0162799 0/20/2014 0/20/2015 WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILRY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE T11A EL. EACH ACCIDENT $ OFFICERIM MBER EXCLUDED? EL DISEASE - FA EMPLOYE S (MyyantlaWry in NH) Of DF. SCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ TI I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (AKach ACORD 101, Additional Remarks Schedule, H more space Is required) City of Fort Collins, its officers, agents and employees are Additional Insured for General Liability per written contract with Insured subject to terms and conditions of the policy contract. City of Fort Collins Purchasing Division 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 _ _ o Sibelius CIC CRM/TM c� 1988-2010 ACORD CORPORATION. All rights reserved. INS025 (201005).01 The ACORD name and logo are registered marks of ACORD