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HomeMy WebLinkAboutLUND-ROSS CONSTRUCTORS INC - INSURANCE CERTIFICATE (2)A" CO CERTIFICATE OF LIABILITY INSURANCE DA TE(MMIDD/YYYY) 12/28/2018 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: The Harry A. Koch Co. PHONE - — LA/c No EX : 402-861-7000 (A/c P.O. Box 45279 (, No): Omaha NE 68145-0279 ADDRESS: INSURER A: The Cincinnati Insurance Co _ 10677 INSURED INSURER B : The Cincinnati Indemnity Co 23280 Lund -Ross Constructors, Inc. 4601 F Street INSURER C : P.O. Box 3688 INSURER D : Omaha NE 68103 INSURERE: COVFRAGF3 CFRTIFICATF N1IMRFR, Rnr,57799n 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 MMIDD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 1K OCCUR EPPG458713 1/1/2019 1/1/2020 EACH OCCURRENCE $1,000,000 DAMACLAIMS-MADE PREMGES Ea ETOREN occurrence $ 500,000 MED EXP (Any one person) $ 10,000 PERSONAL &ADV INJURY $1,000,000 _ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY L X E � LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS AUTOS X HIRED X NON -OWNED AUTOS EPA0458713 1/1/2019 1/12020 COMBINED SINGLE LIMIT Ea accidert $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Pera .dent $ A X UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -MADE EPP0458713 1/1/2019 1/12020 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY OFFICER/MEMBEER EXCLUDED) � (Mandatory in NH) If yes, describe under DE SC RIP FION OF OPERATIONS below N / A EWC04SM30 1/1/2019 1/12020 ER X STATUTE ERH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT _ 1 $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Cyazi112LhG111tm; 1111=M City of Fort Collins PO Box 580 Fort Collins CO 80522-0580 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 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD