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HomeMy WebLinkAboutALLIED CONSTRUCTION MANAGEMENT INC - INSURANCE CERTIFICATEU, 19rKe7kq 611 MEDEROSB ACORO _ �� CERTIFICATE OF LIABILITY INSURANCE DATEMMIDDlYYYY) ( 12/04/2018 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 License # OE67768 Insurance Office of America, Inc. 1451 Route 34, Suite 101 Farmingdale, NJ 07727 NAME:ACT PHONE FAX (732) 751-2900 (a/c,No):(732) 751-2929 E-MAILo,Ext): ADDR: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Travelers Indemnity Company of America 25666 INSURED INSURER B : American Guarantee & Liability Insurance Company 26247 INSURER C : Travelers Property Casualty Company of America 25674 Allied Construction Management Inc. INSURER D: Travelers Casualty Insurance Company of America 19046 2109 Heck Avenue Neptune City, NJ 07753 INSURER E F-.___ --- -- __—.-------------INSURER rnvGoer_Gc rFRTIFIrATF NIIIMRFR• RFVISION 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 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 I T TYPE OF INSURANCE ADDL IN D SUBR WVD POLICY NUMBER POLICY EFF MM/DDNYYY POLICY EXP MM/DDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR Contractual DT-CO-8M468365-TIA-18 12/10/2018 12/10/2019 EACH OCCURRENCE $ 2,000,000 TO RENTED DAMISE Ea occurrence PREM $AGE 300,000 X MED EXP (Any oneperson) $ 10,000 X CGD246 CGD316 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY '( ! PRE �J LOC OTHER; GENERAL AGGREGATE $ 4,000,000 PRODUCTS-COMP/OPAGG $ 4,000,000 EMPL BENEFITS A $ 2,000,000 A AUTOMOBILE LIABILITY JX ANY AUTO OWNED —' SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -AWNED AUTOS ONLY AUTOS ONLY BA-8L950164-18-CNS 12/10/2018 12/10/2019 COMBINED SINGLE LIMIT Ea accdent 1,000,000 $ BODILY INJURY Per person)$ _ BODILY INJURY Per accident $ PROPERTY nDAMAGE $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE AUC 0228668 03 12/10/2018 12/10/2019 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED RETENTION$ $ C WORKERS COMPENSATION ! AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE N OFFICER/MEM BER EXCLUDED? (Mandatory in NH) i yes, ue5 nba nder DESCRIPTION OF OPERATIONS below N / A UB-8M570488-18-26-G 12/10/2018 12/10/2019 X PER H- TAT STATUTE ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYE 1,000,000 $ L D!SEA.SF - POLICY I IMIT 1,000,000 6____ D D Equipment Floater Installation / Build QT6609K949179-TIA-18 QT6609K949179-TIA-18 12/10/2018 12/10/2018 12/10/2019 12/10/2019 Leased/Rented Installation Floater 200,000 1,500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Colllins 215 North Mason Street, 2nd Floor PO Box 580 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) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD