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HomeMy WebLinkAbout537598 BELAIR SITEWORK SERVICES - INSURANCE CERTIFICATE73/25/2019 (MM/DD/YYYY) ACORO® CERTIFICATE OF LIABILITY INSURANCE 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). r420 ODUCER CONTACT rausAnderson Insurance PHONE Certificates DepartmentFAX Gateway Blvd (A/C, N : 952-707-8200 A/c No): 952-890-0535 urnsville MN 55337 ADDRESS: certificates@kainsurance.com INSURED Belair Builders, Inc. dba: Belair Sitework Services dba: Belair Excavating 2200 Old Highway 8 N.W. New Brighton MN 55112 BELABUI-03 INSURERS AFFORDING COVERAGE NAIC # INSURERA: Zurich American Insurance Company 16535 INSURERS: Navigators Insurance Company 42307 INSURERC: American Guarantee and Liability Insurance INSURER E : COVFRAOFR CFRTIFICATF Nl1MRFR• 75RRnrig9 RFVIRION Nl1MRFR 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 SUER POLICY NUMBER MML ICY EFF DDNYYY POLICY EXP MM DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X I OCCUR XCU Coverage Y GLO0507910 4/1/2019 4/1/2020 EACH OCCURRENCE $1,000,000 PREMISES Ea occurrence $ 500,000 X MED EXP (Any one person) $ 10,000 X Contractual Liab PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Y BAP 0507912 4/1/2019 4/1/2020 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ B UMBRELLA LIAB EXCESS LIAR X OCCUR CLAIMS -MADE CH19EXC7265531V 4/1/2019 4/1/2020 EACH OCCURRENCE $10,000,000 X AGGREGATE $10,000,000 DED I X I RETENTION $, $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFF ICER/M EMBER EXCLUDED? FNI (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC 0507913 4/1/2019 4/1/2020 X STERER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The Certificate Holder is an Additional Insured under the Commercial General Liability and Auto Liability when required by written contract., CERTIFICATE HOLDER CANGELLA I IUN City of Fort Collins Director of Purchasing and Risk Management PO Box 580 For Collins CO 80522 USA 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 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD