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HomeMy WebLinkAboutCLARK ENTERPRISES CONSTRUCTION COMPANY - INSURANCE CERTIFICATEAC� ® DATE (MM/DD/YYYY) ��. CERTIFICATE OF LIABILITY INSURANCE 9/19/2018 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 endorsements . PRODUCER CONTACT Renee McReynolds NAME: Y Ewing -Leavitt Insurance Agency, Inc. PHONE (970) 679-7344 AX No: (866)425-6180 4090 Clydesdale Parkway AIL ADDRESS:renee-mcreynolds@leavitt.com Suite 101 INSURERS AFFORDING COVERAGE NAIC N Loveland CO 80538 INSURERAAMCO Ins Co/Nationwide 110127 INSURED INSURER B :Pinnacol Assurance 41190 Clark Enterprises Construction Company INSURER C American Zurich Ins Co 16535 80 Factory Rd. INSURERD: INSURER E : Eaton CO 80615 INSURERF: Cr1VFRAt;FS CFRTIFIrATF NI IMRFR•18-19 update RFVISI(1N IJI IIu19:tFR• 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 POLICY EXP DD1YYYY1 LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE X❑ OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 100 , 000 x MED EXP (Any one person $ 5,000 —Blanket Addl Insured ACP7503133328 1/13/2018 1/13/2019 ongoing operations PERSONAL SADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY a PRO- JECT ElLOC PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea ccident $ 1,000,000 X BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS ACP7503133328 1/13/2018 1/13/2019 BODILY INJURY (Per accident) $ X I PROPERTY DAMAGE Per accident $ HIRED AUTOS X NON -OWNED AUTOS $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 A EXCESS LIAB CLAIMS -MADE DIED I I RETENTION $ ACP7503133328 1/13/201B 1/13/2019 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN x PER OTH- TATUTE ER — ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 100,000 OFFICER/MEMBEB (Mandatory EXCLUDED? ( ) NIA 2330070 10/1/2018 10/1/2019 E.L. DISEASE - EA EMPLOYE $ 100 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 C Builders Risk BR70527256 1/13/2012 nuous$5,000,000 $3,000,000 any one structure $1 , 000 deductible 7 all locations total DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION (970)224-6134 City of Fort Collins 281 N. College Ave. PO Box 580 Fort Collins, CO 80524 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 R McReynolds/RESTEIe;` © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD IIJCn7F ron­