HomeMy WebLinkAbout479201 HEATH CONSTRUCTION - INSURANCE CERTIFICATE (2)P52.2ee2
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A� be CERTIFICATE OF LIABILITY INSURANCE
DATE 4 09/29/201{
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: H the certHcate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WANED, 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 1-303-534-4567
CONTACT
IYA, Inc. - Colorado Division
"ME:.PHONE FAX
(AIC. No. ESU:—_LUNG. Nell
1705 17th Street
E
ADDRESS: dema npamgicorp. cons
Suite too
—
--
Denver, CO 80202
INSURER(S)AFFORDINGWIrERAGE
_ NAICe
INSURERA: PSOSNIY INS CO(Travelers)
25623
INSURED
INSURER B: TRAVELERS IND CO
25658
Heath Construction, LLC
INSURERC: AMERICAN GUAR A LIAR INS(Zurich North
26267
INSURER D: ZURICH ANKH INS CO (Pinnacol Assurance)
16535
PO Drawer R
INSURER E: PINNKCOL AHSUR
61190
Port Collins, CO 80522
INSURER F:
COVERAGES CERTIFICATE NUMBER- 41652313 RFVISInN NIIMRFR-
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 BYPAIDCLAIMS.
LTR ME OF INSURANCE IINesADDL SUBR� YEFF
ppMCY NUMBER YMIDCDITY11 YNDYTY)'LIMNS
A
GENERAL LUBRIIY
DTC0325D325APHXI4
04/30/1
04/30/15
EACH OCCURRENCE
$2, 000, 000
Y COMMERCIAL GENERAL LIABILITY
_
_ 1 CW MSIAADE f XI OCCUR
DAMAGE TO RENTED
PREMISES (Ee occ rre.)_
MED EXP (My.. Person)_
300, 000
$ _ _
$ 10,000
1 2,000,000
PERSONAL A ADV INJURY
GENERAL AGGREGATE
$4.000,000
GENT. AGGREGATE LIMN APPLIES PER:
POLICY FY I1 J LOC
PRODUCTS-COMPIOP AGO
56,000,000
S
B
AUTOYOsaE
usearrY
DT810325D325AIND14
COMBINED SINGLE LIMIT
(Ee eageNJ____
11,000,000
$
Y
ANY AUTO
BODILY INJURY (Per Person)
AIMONEO jI OS AOSSCHEDULED
BODILY INJURY (Per eaJdeni
f
Y
HIRED AUTOS IX NAIOfrN� ED
PROPERTY DAMAGE Bai
.(Per I)
$
S
C
Y
UMBRELLA QAII
Y
OCCUR
AUC596783906
0{/30/1{
Od/30/15
EACHOCCURRENCE
S 10, 000, 000
AGGREGATE
_
$ 10, 000, 000
EXCESSUAB
CLAIMSJAADE
DEOIRETENTION
$
D
B
WORKFR9 COYPEN8ATMIN
AND EMPLOYERS' LIABILJTY YIN
ANY PROPRIETORPARTNER,EXECUTNE
OFFICERIUEJ.IBEREXCLUDEO! NJ
NIA
WC969178404 - Other Star
3096125 - CO
a10/01/1
,
10/01/1�
10/01/15
10/01/15
Y WC STATLL OTH-
—TORYUMIT$._ ER_
ELEACHACCIDENT
$ 1,000,000
EI. DISEASE -EA EMPLOYE
$11000,000
(M.dMerY N NH
NyymmRUTON OF de5nee OPERATIONS baba
OESC
E.L. DISEASE -POLICY LIMIT
$ 1, 000, 000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES leftwh ACORD 101, Adddeew RanwYs 801wduN, N eem opera a re9Wed)
City of Port Collins, Adoin Services Purchasing Division are included as Additional Insureds on the General Liability
Policy if required by written contract or agreement and with respect to work performed by Insured subject to the policy
terse and conditions.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
y of Port Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
In Services Purchasing Division ACCORDANCE WITH THE POLICY PROVISIONS.
BOX 580 AUTHORIZED REPRESENTATIVE /J
t Collins, CO 80522-0580 USA [[[ A/�/� �// •�i,
� 19AR.7010 ACr1Rn CflDRflRATrrM All dnHe. .e.e..,ea
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
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41652313
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