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HomeMy WebLinkAboutAISA CIVIL INC - INSURANCE CERTIFICATE� l ® A� 0 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYYI 10/01/2014 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 endomement(s). PRODUCER Willie of Colorado, Inc. CONTACT NAMEFAX PHONE .1-877-945-7378 AIL No:1-888-467-237B C/o 26 Century Blvd E-MAIL ADDRESS: eertificatee8eillie. one P.O. Sox 305191 Nashville, TN 372305191 USA INSURERS AFFORDING COVERAGE NAICN INSURERA:Zurich American Insurance Company 16535 INSUREDAisa Civil, Inc. INSURERB:American Guarantee and Liability Insurance Cc 26247 INSURERC:Pillnacol Assurance Coampany 41190 Attn: Caeaie Warcellus INSURER D: PO Soz 567 Brighton, CO 80601 INSURE INSURERER F COVERAGES CERTIFICATE NUMBER 14589019 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 AO L UBR POLICY NUMBER POLICYEFF MMIDD EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE FxIOCCUR I DAMAGE TO RENTED REMS y(Ea ocwrrenrel S 300,000 MED EXP An ( Y onePerson) $ 10,000 A.D. Dad.: $5,000 y CPO-4277005-10 10/01/2014 10/01/2015 PERSONAL b ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY FX7 JEOT lxl LOC PRODUCTS - COMP/OP AGG $ 2,000,000 S OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acddent § 1,000,000 BODILY INJURY (Per person) $ X MY AUTO A ALL OWNED SCHEDULED AUTOS AUTOS CPO-4277005-10 10/01/2014 10/01/2015 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON-0WNED HIRED AUTOS AUTOS b B X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE E 2,000,000 EXCESS LIAB CLAIMS -MADE ADD 6554423-14 10/01/2014 10/01/2015 DED I RETENTION EO $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNE11EXECUTIVE YIN OFFICERIMEMSER EXCLUDED'! � (Mandatory In NH) NIA 4086018 10/01/2014 10/01/2015 X PER OTH- STATUTE ER E. L. EACH ACCIDENT g 500,000 E.L. DISEASE - EA EMPLOYE $ 500,000 If yes, desrnbe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD101,A0diti.n.l Remark.Schedule,maybeatMchedifmoreapacei.requlred) Right -of -Nay Candn tractor's License The following are Additional Insures as expects Gaeral Liability only if required by written contract and zo�eraga applies only as respects work performed by the Insured for the Additional Insureds. All coverage terms, conditions and exclusions of the Policy pply. Additional Insureds: City of Fort Collins. CERTIFICATE HOLDER CANCELLATION 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 City of Fort Collins 580 e O e .._ Fort Collin u © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD SR ID:7278141 BATCH:Bstch !: 86762