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HomeMy WebLinkAboutMCCAULEY CONSTRUCTORS INC - INSURANCE CERTIFICATEJ 7 ® AIR" CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 12/27/201 a 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 NAME: Shannon Kammerer Flood and Peterson A/CONNo Ezt : (970) 356-0123 /C No : (970) 330-1867 E-MAIL SKammerer@floodpeterson.com ADDRESS: PO BOX 578 INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Westfield Insurance Company 24112 Greeley CO 80632 INSURED INSURER B : Plnnacol Assurance 41190 INSURER C : McCauley Constructors, Inc. INSURER D : PO BOX 200 INSURER E : INSURER F : Windsor CO 80550 COVERAGES CERTIFICATE NUMBER: x1/1/19-20 Master 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. INTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM DDY[YYYY MM/DDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR 15 PREMISES'Eaoccurrence 500,000 $ MED EXP (Any one person) $ 5,000 PERSONAL BADVINJURY $ 1,000,000 A TRA3373883 01/01/2019 01/01/2020 GEN'LAGGREGATE LIMIT APPLIES PER : GENERAL AGGREGATE $ 2,000,000 POLICY j RO-- LOC CT PRODUCTS - COMP/OP AGG $ 2,000,000 Electronic Data Liability $ 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ A OWNED SCHEDULED AUTOS ONLY AUTOS TRA3373883 01/01/2019 01/01/2020 PROPERTY DAMAGE Per accident $ HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY(per. Uninsured motorist $ 1,000,000 X 19 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS IJAB CLAIMS -MADE TRA3373883 01/01/2019 01/01/2020 AGGREGATE $ 5,000,000 DED I X1 RETENTION $ 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE FN] OFFICER/MEMBER EXCLUDED' �J (Mandatory in NH) NIA 4097236 01/01/2010 01/01/2020 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 1, 000, 000 E.L. DISEASE - EA EMPLOYEE 1,000,000 $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE Contractors License r`FRTIFIr:ATF FIr11 np:R CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins 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