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HomeMy WebLinkAbout147906 SAUNDERS CONSTRUCTION INC - INSURANCE CERTIFICATE (6)P5261912NIX12 $ R' DATE (MMIDDIYYYY) AC"Mn CERTIFICATE OF LIABILITY INSURANCE 05/06/2015 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 endorsement(s). PRODUCER 1-303-534-4567 CONTACT NAME: IMA, Inc. - Colorado Division -PHONYE.. FAX 1Nc<h1q.as4�--._----_._ E-MAIL uDenACCoatTechs@imac0 com 1705 17th Street ADDRESS: _ �• Suite 100 INSURER(S) AFFORDING COVERAGE NAICS Denver, CO 80202 INSURERA: AMERICAN CONTRACTORS INS CO RRG 12300 INSURED INSURER B: TRAVELERS IND CO 25658 Saunders Construction, Inc. INSURER CACIG INS CO 19984 6950 South Jordan Road INSURERD:_-_ INSURER E : Centennial, CO 80112 INSURER F: rnvcoer-cc rFRTImr1kTF NIIMRFR• 43803687 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 ADDL SUBR POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY GL15PA0055 04/30/15 06/01/18 EACH OCCURRENCE $ 5,000,000 A I CLAIMS -MADE I X J OCCUR GL15P80055 (GL XS) 04/30/15 06/01/18 GRENTED PREMIDAMASETOES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 A GL15PCO055 (GL XS) 04/30/15 06/01/18 PERSONAL & ADV INJURY $ 5,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 5,000,000 GEN'L PRODUCTS - COMPIOP AGG $ 5,000,000 POLICY L 1 JE 0. P LOC —-------- $ OTHER: B AUTOMOBILE LIABILITY DT810325P325A15IND 04/30/15 04/30/16 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS X AUTOS PROPERTY DAMAGE (Per accident)-,. -- $ __ ..._ A UMBRELLA LIAB Y OCCUR XS15PDO055 (GL XS) 04/30/15 106/01/18 EACH OCCURRENCE $ 5,000,000 S 5,000,000 X EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTION$ C C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNERJEXECUTIVE � OFFICERIMEMBER EXCLUDED? (Mandatory In NH) NIA WCA000014114-Other State WCA000014214 - KS 10/O1/14 10/01/14 06/01/15 06/01/15 X STATUTE ER $ 1,000,000 $ 1,000,000 E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT If yes, describe under DESCRIPTION OF OPERATIONS below $ 1,000,000 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) RE: Contractor's License #B-119. City of Fort Collins is included as Additional Insured on the General Liability Policy if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. LtK I III -ILA It HULUtK %,APII,CLLA 1 IV 14 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Contractor's License Division ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522-0580 / /// USA L ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD SDZM 43803687 N N z W P526(X)2W)2 829 ADDITIONAL INSURED - AUTOMATIC STATUS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Any person or organization that you are required by contract to include as an additional insured on this policy if the contract is executed prior to the loss. A. Who is an Insured (Section II) is amended to include as an insured any person or organization shown in the above SCHEDULE (called additional Insured), but only with respect to liability for "bodily injury', "properly damage" or "personal and advertising injury' arising out of your premises or your operations for the additional insured. B. The Insurance provided to the additional insured is subject to the following limitations: 1. Unless required by written contract, this insurance does not apply to "bodily injury" or "property damage' occurring after "your work' for the additional insured has been completed or after that portion of "your work" out of which the "bodily injury" or "property damage" arises has been put to its intended use by any person or organization. 2. Unless required by written contract, this insurance does not apply to "bodily injury" or "property damage' arising out of the sole negligence, act or omission of the additional insured. 3. This insurance does not apply to "bodily injury", 'property damage" or "personal and advertising injury" for which the additional insured is obligated to pay damages by reason of the assumption of liability in a contract or agreement except to the extent that the additional insured would have been obligated to pay such damages in the absence of the contract or agreement. 4. This insurance does not apply to "bodily injury', "property damage" or "personal and advertising injury" arising out of the rendering or failure to render any professional services by any insured, Including: a) The preparing, approving or failing to prepare or approve maps, drawings, opinions, reports, surveys, change orders, designs or specifications; or, b) Supervisory, inspection of engineering services. This exclusion applies even if the claims against any Insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured. S. This endorsement shall not apply to a person or organization if any other additional insured endorsement attached to this policy specifically applies to that person or organization. 6. T he insurance afforded herein only applies to the extent permitted by applicable state law, including statutes governing additional insured coverage in the construction Industry. C. This insurance shall not exceed the scope of coverage, including limits, of this policy and in no event shall the Insurance provided to the additional insured exceed the scope of coverage, including limits, required by the contract. If a written contract or agreement requires that additional insured status be provided by the use of specified edition dates of the ISO CG2010 and/or CG2037, then the terms of that endorsement are incorporated into this endorsement as respects such additional insured and shall supersede the coverage grant and limitations in Sections A. and B. of this endorsement. In the event that CG2010 and/or CG2037 are required but no edition dates are specified, the 04/13 editions shall apply. D. This insurance is excess to any other insurance, whether primary, excess, contingent or on any other basis, available to the additional insured unless a written contract requires that this insurance be primary or primary and non-contributing. However, this insurance is always excess to other insurance, whether primary, excess, contingent or on any other basis, when the additional insured has been added to the other insurance as an additional insured. E. Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, provisions, agreements or limitations of the mentioned Policy, other than as above stated. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is Issued subsequent to preparation of the policy.) Endorsement Effective: 4/30/15 Policy No.: GL15PA0055 Endorsement No.: 0 Policy Effective: 4/30115 Premium $ Insured: Saunders Construction, Inc. �f Insurance Company: American Contractors Insurance Company Risk Retention Group / ✓/�� Countersigned By M O N 7 z w P526III12MM2 20S L.L M 0 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY M N This endorsement modifies insurance provided under the following: N COMMERCIAL GENERAL LIABILITY COVERAGE PART z u SCHEDULE Name of Person(s) or Organization(s): Any person or organization for whom you have agreed by written contract to furnish this waiver. The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition (Section IV — COMMERCIAL GENERAL LIABILITY CONDITIONS) is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products -completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. Nothing herein contained shall be field to vary, alter, waive or extend any of the terms, conditions, provisions, agreements or limitations of the mentioned Policy, other than as above stated. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement Is issued subsequent to preparation of the policy.) Endorsement Effective: 4/30/15 Policy No.: GL15PA0055 Endorsement No.: 0 Policy Effective: 4/30115 Premium $ Insured: Saunders Construction Inc. Insurance Company: American Contractors Insurance Company Risk Retention Group Countersigned By