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HomeMy WebLinkAbout549378 LOBOS STRUCTURES - INSURANCE CERTIFICATER CERTIFICATE OF LIABILITY INSURANCE ls.� �19 DATE (MWDO 12/22/2014 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 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 NAM CONTACTAutumn Lee, CISR Moody Insurance Agency, Inc. 8055 East Tufts Avenue PHONE (323)824-6600 FAc o:(303)3T0-0118 nDualE :aleeemoodyins.com Suite 1000 INSURERS AFFORDING COVERAGE NAIC0 INSURER A:Cincinnati Insurance Companies Denver CO 80237 INSURED INSURER B:Plnnacol Assurance 41190 INSURER C: Lobos Structures, LLC 8084 Sherman Street INSURER D: INSURER E INSURER F: Denver CO 80221 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 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. ILTR TYPE OF INSURANCE ADDL AI UBR POLICY NUMBER MWDDY� POLICY LIMITS GENERAL LIABILITY EACH OCCURRENCE E 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TR T PREMISES Ea occurrearcel $ 500,000 A CLAIMS -MADE FxIOCCUR X ENP0140851 /14/2014 /14/2015 MED EXP(My one person) $ 10,000 PERSONAL S ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ 2,000,000 X POLICY PRO - FLOG $ AUTOMOBILE LIABILITY ONBIs.N DSINGLE LIMIT 11000,000 1( BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED NPO140851 /14/2014 /14/2015 AUTOS AUTOS X BODILY INJURY Per accident ( I $ NON-0WNED HIRED Alfr05 AUTOS PROPERTY DAMAGE Pera¢id.t $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ B WORKERS COMPENSATION X VrC STATU- GTH- "MIT ANO EMPLOYERS' LIABILITYY YIN E.L. EACH ACCIDENT It 100,000 ANY PROPRIETORIPARTNER/E%ECUTIVE OFFIGER/MEMBER E%CLUDED9 (Mandatory In NH) NIA 156003 /1/2014 /1/2015 E. L. DISEASE - EA EMPLOYEE $ 100,000 If describe under EL.DISEASE - POLICY LIMIT $ 500,000 Is, DESCRIPTION OF OPERATIONS belay DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Reach ACORD 101, Additional Remarks Sche4ule, H mare space Is required) RE: 8038 Arthur Ditch Wood Street Bridge Replacement. TheCity of Fort Collins is included as an Additional Insured with respect to General Liability as required by written contract, and Automobile Liability. The City of Fort Collins PO Box 580 Fort Collins, CO 80522 ACORD 25 (2010/05) 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 Lee, CISR/AOTLEE ©1988-2010 ACORD CORPORATION. All rights reserved. I Nsuze lgot mst n1 The Ar-nPn nmmm mnd Innn mrm rnnicfnrorl mmr4e of Arnon