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HomeMy WebLinkAboutIDAHO TOWER CONSTRUCTION CO LLC - INSURANCE CERTIFICATEIDAHTOW-01 JWI ACORN DATE (MM/DDIYYYY) �,. CERTIFICATE OF LIABILITY INSURANCE 12/19/2018 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 The Hartwell Corporation PO Box 400 Caldwell, ID 83606 INSURED Idaho Tower Construction Co. LLC 400 S. Main St., Unit 201 Hailey, ID 83333-8481 CONTACT Audrey L. Subin NAME: PA CNN . Extl: (208) 522-5656 (AM. No):(208) 524-5721 INSURER F : Idaho .Corn Cr1VERAnEC 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 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 POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FV1 OCCUR ENP 0272159 12/31/2018 12/31/2019 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED MI E Eaoccurrence) 500,000 MED EXP An one person)1,000, 000 $ 10,000 PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY F V7 jEaT LOC OTHER. GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 EBL AGGREGATE 3,000,000 A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -AWNED AUTOS ONLY AUTOS ONLY EBA 0272159 12/31/2018 12/31I2019 EOMBINED SINGLE LIMIT a accident) $ 1,000,000 BODILY INJURY Perperson) $ BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE ENP 0272159 12/31/2018 12/31/2019 EACH OCCURRENCE $ 6,000,000 AGGREGATE $ 6,000,000 DED RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ W.FICER/MEMBER EXCLUDED? (Mndatoryin NH) if yes describe under DESCRIPTION OF OPERATIONS below N / A 644651 7/112018 7/1/2019 X I PER UTE OTH- STAT ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYE 1,000,000 $ E.L. DISEASE -POLICY LIMIT 1,000,000 A Installation / Build ENP 0272159 12/31/2018 12/31/2019 Any One Location 250,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins 281 N College 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. AUTHOR IZED REPRESENTATIVE wi,<-0-1) ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD