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Home My WebLink About380591 J2 CONTRACTING COMPANY INC - INSURANCE CERTIFICATE (5)A C>R O® VCERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 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 CONTACT Jennifer Winter, CISR NAME: Flood and Peterson PHONE (g70) 506-3206 FAX (970) 506-6846 IAIC,N Ex : AIC No E-MAIL JWinter@floodpeterson.com ADDRESS: PO Box 578 INSURER($) AFFORDING COVERAGE NAIC # INSURER A: Phoenix Insurance Company 25623 Greeley CO 80632 INSURED INSURER B : Travelers Indemnity Company 25658 J2 Contracting Company, Inc. INSURER C : Travelers Property Casualty Company of America 25674 105 Coronado Court, Suite Al01 INSURER D : Pinnacol Assurance 41190 INSURER E : Fort Collins CO 80525 INSURER F : COVERAGES CERTIFICATE NUMBER: CL18121926701 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDNYYY XP MMIDDYIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 � CLAIMS -MADE OCCUR N PREMISES Ea occurrence $ 300,000 X MED EXP (Any one person) $ 5,000 PD Ded:2,500 PERSONAL& ADV INJURY $ 1,000,000 A DTC0325D6576PHX18 01/01/2019 10/01/2019 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 XPRO- LOC JECT PRODUCTS-COMP/OPAGG 2,000,000POLICY❑ $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANYAUTO B OWNED SCHEDULED AUTOS ONLY AUTOS 8102L9156611826G 01/01/2019 10/01/2019 BODILY INJURY (Per accident) $ PROPERTYDAMAGEAUTOS Per accident $ HIRED HNON-OWNED ONLY AUTOS ONLY X $ DOC X UMBRELLA LIAB PxX_01 CUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 C EXCESS LIAB CLAIMS -MADE CUP9H7218771826 01/01/2019 10/01/2019 DED I X RETENTION $ 10,000 $ WORKERS COMPENSATION PER AND EMPLOYERS' LIABILITY Y I N X1 STATUTE ORH E.L. EACH ACCIDENT $ 1,000,000 D ANY PROPRIETOR/PARTNER/EXECUTIVE N/A 3114522 10/01/2018 10/01/2019 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) RE: Contractors License The City of Fort Collins is listed as an Additional Insured as respects General Liability. Insurance is primary and non-contributory. A 30-day written notice of cancellation applies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins Attn: Engineering Department ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins CO 80522-0580 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD