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HomeMy WebLinkAbout499821 STRUCTURES INC - INSURANCE CERTIFICATE (4)ACORD, CERTIFICATE OF LIABILITY INSURANCE 12/31 /2019 F DATE(MMIDD/VYYY) 12/ 17/2018 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 Lockton Companies 8110 E Union Avenue Suite 700 Denver CO 80237 CONTACT NAME: A/C No Ext : A/C No E-MAIL ADDRESS: INSURER AFFORDING COVERAGE NAIC # (303) 414-6000 INSURER A: The Charter Oak Fire Insurance Company 25615 INSURED Structures, Inc 1455024 4 Inverness Court East, Suite 250 Englewood, CO 80112 INSURERB: Travelers Property Casualty Co of America 25674 INSURER C : The Standard Fire Insurance Company 19070 INSURER D : INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: 15710654 REVISION NUMBER: XXXXXXX 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 INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP (MMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY Y N DT-CO-1L581505-COF-18 12/31/2018 12/31/2019 EACH OCCURRENCE 1,000.000 CLAIMS -MADE � OCCUR PREMISESOEa RENTED 300,000 MED EXP (Any oneperson) 5,000 PERSONAL & ADV INJURY $ 1,000.000 GEN'L AGGREGATE LIMIT APPLIES PER. POLICY JERCOT- ❑ LOC GENERAL AGGREGATE $ 2,00000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER. A AUTOMOBILE LIABILITY N N D'I'-810-1 L581505-COF-18 12/31/2018 12/31/2019 Ea COMBINEDaccldenSINGLELIMIT $ 1 OOO OOO X BODILY INJURY (Per person) $ XXXXXXX ANY AUTO OWNEDONLY SCHEDULED AUTOSAUTOS BODILY INJURY (Per accident $ XXXXXXX PROPERTY DAMAGE Per accident $ XXXXXXX HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $XXXXXXX B UMBRELLA LIAB X OCCUR N N CUP-9M281209-18-26 12/31/2018 12/31/2019 EACH OCCURRENCE $ 51000,000 ){ AGGREGATE $ 51000,000 EXCESS LIAR CLAIMS -MADE DIED I I RETENTION $ $ XXXXXXX L WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANYPROPRIETOR ER/EXCLUDED? ECUTIVE -1 (Mandatory in NH) If yes, descnbe under DESCRIPTION OF OPERATIONS below N / A N 007J03575A-19-26 1/l/2019 1/l/2020 TH- X STATUTE DER EL EACH ACCIDENT $ 1,000,0 00 E.L. DISEASE EA EMPLOYEE 1,000.000 E.L. DISEASE - POLICY LIMIT �1 1,000,000 B Scheduled Contractors Equip Leased/Rented Equip N N QT-630-9M300505 l'IL-18 11/31/1011 11/31/2019 Limit $4,165,300 Limit $400.000 Deductible $1,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: 7338 Troutman Court East #250 City of Fort Collins and State of Colorado are named as an additional insured with respect to General Liability. 1-11,A l t rf 15710654 City of Fort Collins Financial Services Purchasing Division 215 N Mason St, 2nd floor PO Box 580 Fort Collins CO 80522 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 ACORD 25 (2016103) ©1988-2015 ACORD CORPMRATION- All rinhtc rpsprvprl The ACORD name and logo are registered marks of ACORD