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HomeMy WebLinkAbout108951 HALL IRWIN CORPORATION - INSURANCE CERTIFICATE (3)AC� ® DATE (MM/DD/YYYY) IllC" CERTIFICATE OF LIABILITY INSURANCE F12/21/2018 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 CONTACT NAMECommercial Risk Solutions PHONE FAX Smothers 6600 E Hampden Ave Ste 200 PHONNo,E 303-996-7801 aAxc No ; 303-757-7719 Denver CO 80224 ADMDDRIL : ksmothers crsdenver.com INSURER(S) AFFORDING COVERAGE NAIC S INSURER A: United Specialty Insurance Co INSURED HALIR-1 INSURERS: Westfield Insurance 241'12 Hall -Irwin Corporation _..-______. __._ ___.-____.... -+_---,._-_ 301 Centennial Drive INSURERC: PinnacolAssurance_ ^ 41190 Milliken CO 80543 INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMRFR- 2n4A151421 RFVIRIAN 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. __ _ ' AINSDDD Tp TYPE OF INSURANCE i POLICY NUMBER MMDD YYYY MMUDD YYXYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y ATN-SF1843368 12/31/2018 ! 12/31/2019 - EACH OCCURRENCE $1,000,000 __... CLAIMS MADE %� OCCUR PRAI$E$ jF�l o� r $ 50 000 _ MED EXPAny oneperso L_ $ 5 000 --- _ X VJY EL Stoo (ap_ PERSONAL 8 ADV INJURY $1,000,000 — GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X PRO - POLICY X POLICY JECT LOC _ ----- - PRODUCTS - COMP/OP AGG — -- -_ $ 2,000,000 OTHER: Sto Ga Lieblli $1,000,000 B AUTOMOBILE LIABILITY _ V TRA7976721 12/31/2018 12/31/2019 COMBINED IN L LIMIT (Ea__accident $1,000,000 $ X ANY AUTO BODILY INJURY (Per person) OWNED SCHEDULED AUTOS ONLYAUTOS BODILY INJURY (Per accident) $ X HIRED NON -OWNED PX PkbPP RnDAMAGE $ AUTOS ONLYAUTOS ONLY $ A UMBRELLAUA13 X OCCUR BTNI845097 12/31/2018 12/31/2019 EACH OCCURRENCE (— $5,000,000 X EXCESS UAB CLAIMS -MADE AGGREGATE $ 5,000,000 _ _ DED ^ RETENTION $ $ C WORKERS COMPENSATION 4021105 1/1/2019 1/1/2020 X PEAT TRH. AND EMPLOYERS' LIABILITY YIN - ANYPROPRIETOR/PARTNER'EXECUTIVE 7N OFFICER'MEMBEREXCLUOE07 IN / A E.L. EACH ACCIDENT --'- - $ 500 000 - (Mandatory In NH) I ' E.L, DISEASE EA EMPLOYEE $ 500 000 II yes. describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 8 Leased and Rented Equipment TRA7976721 12/31/2018 12/31/2019 Limit 500.000 Special Form/ACV/100% Coinsurance Deductible 2.500 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Re: 8519 Maple Hill Neighborhood The City of Fort Collins is included as additional insured for ongoing operations on the General Liability and included as additional insured on the Auto Liability with respect to operations of the named insured for the certificate holder as required by written contract. All policy terms, conditions and exclusions apply. Utr1 I It-IL;A I t ML)LULH City of Fort Collins Purchasing 215 N Mason St, 2nd Floor PO Box 580 Fort Collins CO 80522 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 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 3of3 80 1