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HomeMy WebLinkAboutASPEN CONSTRUCTION - INSURANCE CERTIFICATEACORa `� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 1 51/2019 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 UUNIACI NAME: Paula Blohm Madison Insurance Group P FAX PHONE 3033220800 3033220874 A/C No Ext : (A/C, No): ADDRESS: pblohm@madisoninsurance.net 600 South Cherry St, Ste 900 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: PINNACOL ASSURANCE 41 190 Denver CO 80246 INSURED INSURER B: AUTO OWNERS INSURANCE INSURER C : BERKLEY ASSURANCE COMPANY Aspen Construction Enterprises, Inc dba Aspen Construction INSURER D : NATIONAL UNION FIRE INSURANCE COMPANY 204 N. Link Lane #3 INSURER E : INSURER F : Fort Collins CO 80524 COVERAGES 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS C X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR VUMB0198010 04,29,2019 04129,2020 EACH OCCURRENCE $ 1,000,000 PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ Excluded PERSONAL aADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. POLICY E PRO- LOC JOTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 50-675-828-00 04/28/2019 04/28/2020 (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ DAMAGE (Per accident) $ D UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -MADE EBU016219098 04,,29/2019 04202020 EACH OCCURRENCE $ 1,000,000 X AGGREGATE $ 1,000,000 DED RETENTION $ $ A ORKERS COMPENSATION ND EMPLOYERS' LIABILITY Y / N NY PROPRIETOR/PARTNER/EXECUTIVE FFICER/MEMBER EXCLUDED? Mandatory in NH) f yes, describe under DESCRIPTION OF OPERATIONS below N / A 3018240 06/01/2019 06/01/2020 ER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ SGO,GOG B Contractor's Equipment 74675928 04/29 2019 04/29/2020 Scheduled Equipment Deductible $32,295 $1,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) l�la:Ul7Nfi\la:[�l��la: N_VCya��a\I[�]C City of Fort Collins Utilities 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 Pa.�aal t3t.o{,«. ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD