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HomeMy WebLinkAbout391229 SITEWISE LLC - INSURANCE CERTIFICATEClient#: 1483410 PEAKUTI ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1 9/28/2018 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER USI Colorado, LLC Construction NAME: Client Manager PHONE g00 873-8500FAX A/C No E:n : Arc No): 303-831-5295 P.O. Box 7050 E-MAIL den.contractorsC�usi.com ADDRESS: Englewood, CO 80155 800 873-8500 INSURER(S) AFFORDING COVERAGE- NAIC# INSURER A: Arch Insurance Company 11150 INSURED Sitewise, LLC 4725 Independence Street, Suite 100 Wheat Ridge, CO 80033 INSURER B : Allied World Specialty Insurance Compan 16624 INSURER C INSURERD: --- INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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 ADDLSUBR INSR WVD POLICY NUMBER ZAGLB9220702 ZACAT9242602 POLICY EFF (MM/DD/YYY POLICY EXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I ^I OCCUR X X X X 10/01/2018 0/01 /2018 10/01/2019 10/01 /201 EACH OCCURRENCE $5000000 PREMISESOE.occurence $100000 MED EXP (Any one person) $10 000 PERSONAL & ADV INJURY s5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY CTT — LOC X I7 En OTHER: GENERAL AGGREGATE $5 000,000 PRODUCTS - COMP/OP AGG s5,000,000 COMBINED SINGLE LIMIT Ea accident 5,000,000 A AUTOMOBILE LIABILnY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY X NON -OWNED AUTOS ONLY X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ _ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE X X 03115397 0/01/2018 10/01/2019 EACH OCCURRENCE S7,000,000 AGGREGATE s7,000,000 DIED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE / N OFFICER/MEMBEREXCLUDED? � (Mandatory In NH) Uesdescribe under RIPTION OF OPERATIONS below N/A X ZAWC19401302 10/01/201810/01/201 X PER ORH- E.L. EACH ACCIDENT — $1 OOO OOO E.L. DISEASE - EA EMPLOYEE — $1 000 000 E.L. DISEASE - POLICY LIMIT $1 000 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) As required by written contract or written agreement, City of Fort Collins is included as Additional Insured as respects General Liability but only as respects work performed on behalf of the named insured. L;tH I It-II;A I h HULUtH City of Fort Collins P.O. Box 580 Fort Collins, CO 80522-0580 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 (2016/03) 1 of 1 #S23967560/M23947523 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD JXDZP