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HomeMy WebLinkAbout101027 HENSEL PHELPS CONSTRUCTION CO - INSURANCE CERTIFICATE (3)ACOR" CERTIFICATE OF LIABILITY INSURANCE
DATE( ) /./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 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 NAME: Rebekkah McGuire
A/CONE No Ext: (970)356-0123 A/C NO; (970)330-1867
Flood and Peterson
E-MAIL RMcGuire@F1oodPeterson.com
ADDRESS:
PO Box 578
INSURERS) AFFORDING COVERAGE
NAIC #
INSURERA:Zurich American Insurance Company
16535
Greeley CO 80632
INSURED
INSURERS: American Guarantee and Liability Insure
26247
INSURER C: Steadfast Insurance Company
26387
Hensel Phelps Construction Co.
INSURERD:XL Insurance America, Inc.
24554
Plains District
INSURERE:
12121 Grant Street; Suite 410
INSURERF:
Thornton CO 80241
COVERAGES CERTIFICATE NUMBER:CL18102225649 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 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
SUBR
POLICY NUMBER
E
MM DDYYYY
MM/DD YYYY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 5,000,000
A
CLAIMS -MADE �X OCCUR
DAMAGE TRENTED
PREM SESOEa o c."erce
$ 300,000
MED EXP (Any one person)
$
GL0369726414
1/1/2019
1/1/2020
PERSONAL BADVINJURY
$ 5,000,000
GEN'L AGGREGATE LIMIT APPLIES PER.
GENERAL AGGREGATE
$ 10,000,000
POLICY Fx—] JE� LOC
PRODUCTS - COMP/OPAGG
$ 10,000,000
$
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 5,000,000
BODILY INJURY (Per person)
$
A
X ANYAUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
SAP369726114
1/1/2019
1/1/2020
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
NON -OWNED
X HIREDAUTOS X AUTOS
B
X
UMBRELLA LIAB
X
OCCUR
AUC928038417
1/1/2019
1/1/2020
EACH OCCURRENCE
$ 50, 000, 000
AGGREGATE
$ 50,000,000
D
EXCESS LIAR
CLAIMS -MADE
DED RETENTION $
$
US00068961LI19A
1/1/2019
1/1/2020
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE �I�N �N/A
OFFICER/MEMBER EXCLUDED? L 1
(Mandatoryin NH)
aC369726515
li1i 201S
1/ij2020
X PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$ 1,000,000
EL DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
C
Prof E: s Sional and Pollution
EOC937461715
1/1/2019
1/1/2020
Each Occurrence $50,000,000
Liability
Aggregate $50, 000, 000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Elizabeth 1864 LLC; MFCH AI, LLC; MFCH NC, LLC; Mcwhinney Real Estate Services, Inc. Sage Old Town FC
Investor LLC; Sage Old Town FC Promote LLC; Sage Client 207, LLC; Sage Hospitality Resources, LLC, Sage
Hotel Capital LLC, and their respective asset managers, managers, members, principals, officers,
directors, shareholders, employees, agents, lenders, successors, assigns, volunteers and any affiliated
parent or subsidiary companies are additional insureds.
CERTIFICATE HOLDER CANCELLATION
j30l6l83@henselphelps.com
City of Fort Collins
215 N Mason St.
Fort Collins, CO 80524
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
Keiser, CISR/NKEISE %A&j&sv
All rights reserved
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
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