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HomeMy WebLinkAboutLUND-ROSS CONSTRUCTORS INC - INSURANCE CERTIFICATEACORO® CERTIFICATE OF LIABILITY INSURANCE DAM,MM/°°"""' 12/23/2014 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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms'andconditions of the policy, certain policies may require an endorsement. A statement on this certificate tloes not confer,rights to the - certificate holder ie'lieu of such endorsements . - — PRODUCER - - - CONTACT NAME: The Harry A. Koch CO. P.O. Box 45279 Omaha NE 68145-0279 PHONE 4 -INC,No EMAIL ADDRESS INSURERS AFFORDING COVERAGE NAIC IF INSURERA: INSURED INSURERB -Th In inn i Indemnity Co 232aO— INSURER C: Lund-Ross Constructors, Inc. INSURER D 4601 F Street P.O. Box 3688 Omaha NE 68103 INSURER E: ' INSURER F: COVERAGES CERTIFICATE NUMBER: 1153801343 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 IINSR TYPE OF INSURANCE A OL IPOLICY MD NUMBER EFFEXP MMIDDVYYYY MMIOOYIVYYY LIMITS A _ GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE IT] OCCUR PP0816276 1/1/2015 11/2016 EACH OCCURRENCE $1,000,000 DAMA ET RENT D PREMISES Eaoccurrenoa $500.000 MED EXP (Any one person) $10,000 PERSONAL B AOV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN_'L,AGGREGATE LI MIT APPLI ES PE R POLICY X 7PR0. ''-.� •LOC• FQT PRODUCTS- COMP/OP AGG $2,000,000- A AUTOMOBILE X X LIABILITY ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X AUOTOS NON-OWNED CPA0816276 1/1/2015 - /1/2016 Ea acddenl $1 000 000 BODILY INJURY (Per person) $ BODILY INJURY(Peraccidenl) $ Par acciden DAMAGE $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CPP0816276 1/1/2015 1/1/2016 1 EACH OCCURRENCE $10,000,000 AGGREGATE $10.000,000 DED I I RETENTIONS $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOWPARTNEWEXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA C186461801 1/1/2015 1/1/2016 X WC STATU- TORY I OTH- ER EL EACH ACCIDENT $500,000 EL. DISEASE - EA EMPLOYE $500.000 EL. DISEASE - POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) ' City of Fort Collins PO Box 580 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 REPRESENTATIVE �doeT% ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD