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Home My WebLink About476108 INTERSTATES CONSTRUCTION SERVICES INC - INSURANCE CERTIFICATE (3)ACORO' CERTIFICATE OF LIABILITY INSURANCE 16._� 9/1/2019 F DATE(MM/DDIYYYY) 1 8/28/2018 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 have ADDITIONAL INSURED provisions or 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 Lockton Companies 444 W. 47th Street, Suite 900 Kansas City MO 64112-1906 (816) 960-9000 CONTACT NAME: HONE FAX A/C, No, Ext : A/c, No): E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: The Travelers Indemnity Company 25658 INSURED INTERSTATES CONSTRUCTION SERVICES INC. 1450806 PO BOX 260 SIOUX CENTER IA 51250-0260 INSURER B : The Travelers Indemnity Co of America 25666 INSURER C : Travelers Property Casualty Co of America 25674 INSURER D : Travelers Indemnity Co of CT 25682 INSURER E : INSURER F COVERAGES* CERTIFICATE NUMBER: 15558451 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 WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP (MM/DDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY Y N VTK-CO-7164B73-7-IND-18 9/1/2018 9/1/2019 EACH OCCURRENCE 1,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence SOO OOO MED EXP (Any oneperson) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. POLICY PE� ❑ LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY Y N VTHCAP7164B749TIA18 9/1/2018 9/1/2019 COaBINEDtSINGLE LIMIT $ 1 000 000 X BODILY INJURY (Per person) $ XXXXXXX ANY AUTO AUTOS ONLY SCHEDULED BODILY INJURY (Per accident $ XXXXXXX AUTOS ONLY NON-OWNED ONLDY perr acad ntDAMAGE $ XXXXXXX $ XXXXXXX C X UMBRELLA LIAB NCLAIMS-MADE OCCUR N N ZUP-21PI5736-19-NF 9/1/2018 9/1/2019 EACH OCCURRENCE $ 10 000 000 AGGREGATE $ 10,000,000 EXCESS LIAB DED I X I RETENTION $ 10,000 $ XXXXXXX D WORKERS COMPENSATION AND EMPLOYERS' LABILIITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in aNH)nd If Dyes, describe under DESCRIPTION OF OPERATIONS below N / A N VTC2E-UB-2792C83-A-18 9/1/2018 9/1/2019 X I STATUTE I I OER E.L. EACH ACCIDENT $ 1 000 000 E.L. DISEASE - EA EMPLOYEE !\ $ 1 000 000 E.L. DISEASE - POLICY LIMIT 13000,000 C _ LEASED/RENTED EQUIPMENT N N QT-630-2L074879-TIL-18 9/1/2018 9/1/2019 $500,000 PER OCCURRENCE DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THE CITY OF FORT COLLINS, CO, ITS OFFICERS, AGENTS, AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSUREDS ON THE GENERAL AND AUTO LIABILITY WHEN REQUIRED BY WRITTEN CONTRACT. CERTIFICATE HOLDER CANCELLATION 15558451 CITY OF FORT COLLINS ATTN: PURCHASING PO BOX 580 FORT COLLINS CO 80521 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 ACORD 25 (2016/031 n 1 R-2015 ACORD CORPORATION- All riahts reserved The ACORD name and logo are registered marks of ACORD