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HomeMy WebLinkAboutK.E.C.I. COLORADO INC - INSURANCE CERTIFICATEACORD- CERTIFICATE OF LIABILITY INSURANCE 1 / l /2019 F DATE(MM/DD/YYYY) 1 9/6/201 8 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 CT NAME: PHONE x A/C No Ext : A/C No): 8110 E Union Avenue Suite 700 Denver CO 80237 E-MAIL ADDRESS; INSURER AFFORDING COVERAGE NAIC # (303) 414-6000 INSURER A: The Charter Oak Fire Insurance Company 25615 INSURED K.E.C.I. Colorado, Inc. INSURER B : The 'travelers Indemnity Co of America 25666 1050899 5750 W. Airport Rd. Sedalia, CO 80135 INSURER C : Pinnacol Assurance INSURER D : travelers Property Casualty Co of America 25674 INSURER E : INSURER F : COVERAGES KECCO03 CERTIFICATE NUMBER: 12439811 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 IN D SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE IX OCCUR Limited Jobsite Y N DTC06C647481CCIF18 I/l/2018 1/l/2019 EACH OCCURRENCE 1,000,000 PREM PREMISES (Ea oGE TO ccurrence) 300,000 X MED EXP An one person)5,000 Pollution PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. POLICYPE a J LOC OTHER. GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO AUTOS ONLY AUWNED OS SCHEDULED AUTOS ONLY X AUUTOS ONL� Y N DT810325D9148TIA18 1/l/2018 1/l/2019 (CEO, .'d.niSINGLEUMIT $ 1 000000 BODILY INJURY (Per person) $ j(�(�(�(xxx Ix BODILY INJURY (Per accident $ �()(�(](}(}()( Peer accRdentDAMAGE $ XXXXXXX $XXXXXXX D X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE N N CUPOJ4047221826 1/1/2018 1/l/2019 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 51000,000 DED I X I RETENTION $ 10,000 $ XXXXXXX C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? FN (Mandatory in NH) It yes, describe under DESCRIPTION OF OPERATIONS below N / A N 4048534 10/1/2018 1O/1/2019 X STATUTE I PEROER E.L. EACH ACCIDENT �l $ SOU OVO E.L. DISEASE - EA EMPLOYEE 500,000 E.L. DISEASE - POLICY LIMIT s500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: 7519 Lemay Ave Bridge Expansion Joint. 'I he City, its officers, agents and employees are additional insured as respects General and Auto Liability if required by written contract per policy terms and conditions. Ten(10) 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 Purchasing Department PO Box 280 Ft Collins CO 80522 tIC l"1 I�+I ACORD 25 (2016/031 ©1 8 2015 ACORD CC ATION. All rights reserved The ACORD name and logo are registered marks of ACORD