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HomeMy WebLinkAbout601609 MYERS & SONS CONSTRUCTION LP - INSURANCE CERTIFICATE (2)AC� 0 DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 5/20/2019 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 CONTACT NAME: Laura Martino Uniondale-Alliant Ins Svc Inc PHONE 516-414-8606 n/ac No: 333 Earle Ovington Blvd Ste 700 IAIC_M Uniondale NY 11553 ADDRESS: Laura. MartinDinalliant.COm INSURER A: Berkshire Hathaway Specialty Insurance Company 22276 INSURED STERCON-04 INSURER B : Executive Risk Indemnity Inc 35181 Myers & Sons Construction, L.P. 4600 Northgate Blvd., Suite 100 INSURER C: Federal Insurance Company Can 20281 Sacramento, CA 95834 INSURER D : INSURER E : COVERAGES CFRTIFICATF NIIMRFR- 17ARAl-I AR RFVISI(]N NIIMRFR- 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 I TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MWDDNYYY POLICY EXP MWDD/YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [XI OCCUR Contractual Liab Y Y 54309707-01 6/1/2019 6/1/2020 EACH OCCURRENCE $2,000,000 _ $ 300,000 DAMAGE T RENTED PREMISES Ea occurrence X MED EXP (Any one person) _ $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 $ 4,000,000 $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 1 JE07 LOC OTHER: GENERAL AGGREGATE PRODUCTS - COMP/OP AGG $ C AUTOMOBILE X LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY Y Y (19)5430-97-19 6/1/2019 6/1/2020 COMBINED SINGLE LIMIT Ea accident $2,000,000 $ $ $ BODILY INJURY (Per person) BODILY INJURY (Per accident) X PROPERTY DAMAGE Per accident $ A UMBRELLA LIAB X EXCESS LIAB X OCCUR CLAIMS -MADE Y Y 47-XSF-303345-03 6/1/2019 6/1/2020 EACH OCCURRENCE $25,000,000 AGGREGATE $ 25,000,000 DED X RETENTION $ _ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBE R EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A Y 005 4309720 02 6/1/2019 6/1/2020 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 _ $ 1,000,000 E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Service Agreement — Work Order Type / 8267 CMGC Services for Horsetooth & College Intersection Improvements The City of Fort Collins is included as Additional Insured as respects Liability arising out of work performed by the Named Insured as required by written contract. The insurance provided shall be primary and any other insurance maintained by the Additional Insured is excess and non-contributory. Waiver of Subrogation applies as required by contract. 30 days' notice of cancellation or non -renewal will be provided to Certificate Holder, except 10 days' notice for cancellation for non-payment of premium. CERTIFICATE HOLDER 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. Attn: Purchasing Department PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 41141 .. 1#;X� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD