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HomeMy WebLinkAbout521604 KECI COLORADO INC - INSURANCE CERTIFICATE (3)ACORD. CERTIFICATE OF LIABILITY INSURANCE Io/uzols IDATE/31/2014 I2/31/2014 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 PRODUCER Lockton Companies 8110 E Union Avenue Suite 700 Denver CO 80237 (303) 414-6000 CONTACT h FAX A/C No Est): A/C No: E-MAIL JNSURERISI AFFORDING COVERAGE NAIC INSURER A: The Charter Oak Fire Insurance Company 25615 INSURED K.E.C.I. Colorado, Inc. 1050899 5750 W. Airport Rd. Sedalia, CO 80135 INSURER B: The Travelers Indemnity Company 25659 INSURER C : Pinnacol Assurance INSURER D CnVFRALIFS KFCCnU3 CFRTIFICATF NtIMRER- 12439R1 I REVISION NUMBER: XXXXXXX 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 ADDL INSD SUBR VWD POLICY NUMBER POLICY EFF IMMIDD I POLICY UP flMMIDDIYYY)`1LIMITS A X COMMERCIALGENERALLIABILITY CLAIMS -MADE � OCCUR Limited Jabsite Y N DTC06C647481 1/l/2015 1/12016 EACH OCCURRENCE 1 000000 PRREMISES Ea o¢Tu orree 300,000 X MED UP (My oneperson) 5,000 Pollution PERSONAL B ADV INJURY s 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC OTHER GENERAL AGGREGATE s2000000 PRODUCTS - COMP/OP AEG s 2000000 $ B AUTOMOBILE LIABILITY ANYAUTOBODILY AUTOBNED SCHEDULED UTOS HIRED AUTOS X AUTOSWNED Y N DT810325D9][48 1/I/2015 1/l/2016 Ea OMBIEeDISINGLE LIMIT $ I OOO OOO X INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident $ XXXXXXX X PROPERTY accidenDAMAGE $ XXXXXXX $XXXXXXX B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE N N DTSMCUP325D9148 1/l/2015 I/l/2016 EACH OCCURRENCE $S000000 AGGREGATE $ 5,000.000 DED I X I RETENTION$ 10,000 $ XXXXXXX C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETORMARTNERE ECoroVE ❑ OFFICERMEMBER E%DWOi N (Manaalery in NHl It ties, o, under DESCRIPTION OF OPERATIONS Ni NIA N 4049534 10/1/2014 10/1/2015 X STATUTE OTH- EL EACH ACCIDENT s 500000 E.L. DISEASE - EA EMPLOYEE s 500000 EL MSEASE-POLICY LIMIT 500000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IAKach ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: 7519 Lemay Ave Bridge Expansion Joint. The City, its officers, agents and employees are additional insured as respects General and Auto Liability if required by written contract per policy terns and conditions. Tent][0) Day Notice of Cancellation will be provided to the City for non-payment. 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. 12439811 AUTHORIZED REPRESENTATIVE City of Fort Collins Purchasingg Department PO Box 280 Ft Collins CO 80522 rlc N� IVl ACORD 25 (2014101) ©1 5 2014 A .ORD CORPOKATION. All rights reserved The ACORD name and logo are registered marks of ACORD