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Home My WebLink About479201 HEATH CONSTRUCTION - INSURANCE CERTIFICATE (5)Psiwa...... 0 g 2b DATE (MM/DDNYYY) ACORO CERTIFICATE OF LIABILITY INSURANCE 10/01/2018 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 1-303-534-4567 CONTACT NAME: INA, Inc. - Colorado Division PHONE FAX JAIL, ---- UIC. Nol: -- 1705 17th Street E-MAIL DBaAcc011ntTechs@imaco COR ADDRESS: �• Suite 100 -_ INSURERS AFFORDING COVERAGE NAIC8 Denver, CO 80202 INSURERA:HARTFORD FIRE IN CO 19682 INSURED INSURERS: TRUMBULL INS CO (Hartford insurance Co) 27120 Heath Construction, LLC dba SaundersHeath INSUCXMDURANCE AMER INS CO RER 10641 INSURERD: PINNACOL ASSUR 41190 141 Racquette Drive P.O. Box Drawer H INSURERE: Fort Collins, CO 80522 INSURERF: r`nvro AC CC re0TIC1r ATC MnuaFa- 54195335 RFVI-910N NIIMRFR- 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 ADDL SUER POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIDDIYYYY A X COMMERCIAL GENERAL LIABILITY 34UEAZT7859 04/30/18 04/30/19 EACH OCCURRENCE i 1,000,000 CLAIMS -MADE � OCCUR PREMISES EaEoccurrence) f 300,000 X MED EXP (Any one person) f 10,000 $5, 000 PD Deductible PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE f 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OPAGG i 2,000,000 POLICY � PET LOC f J OTHER: B AUTOMOBILE LIABILITY 34URAZT7860 04/30/18 04/30/19 COMBINED SINGLE LIMIT faacciden�_-_ : 1,0001000 BODILY INJURY (Per person) f _ X ANY AUTO BODILY INJURY (Per accident) i OWNED SCHEDULED AUTOS ONLY _ AUTOS HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY PROPERTY DAMAGE Per accident - f -__- f C X UMBRELLA LIAB OCCUR XSC30000649200 04/30/18 04/30/19 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10, 000, 000 EXCESS LIARM tc S-MADE __UR DED R_IETENTI $ f D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNERIEXECUTIVE a OFFICER/MEMBEREXCLUE (Mandatory In NH) NIA 3096125 - Colorado 10/01/18 10/01/19 X STATUTE I I FOR E.L. EACH ACCIDENT = 1,000,000 E.L. DISEASE - EA EMPLOYEE S 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H mom space Is required) City of Fort Collins and State of Colorado are included as Additional Insureds on the General and Automobile Liability Policies if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. CtKIItICAIt r7ULUtK a,nr��,ccv+nvr� RE: 7675 South Transit Center - Bike Shelter Addition. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. I300 Laporte Ave. (Fort Collins, CO 80522 USA AUTHORIZED REPRESENTATIVE / Z& U 19BB-2015 ACUKU GUKPUKA I TUN. All rlgniS reserves. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 2018spm60 54195335