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HomeMy WebLinkAboutTHUNDERPUP CONSTRUCTION INC - INSURANCE CERTIFICATE� ® DATE (MM/DD/YYYY) A C" CERTIFICATE OF LIABILITY INSURANCE 3/28/2019 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 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 endorsements . PRODUCER CONTACT Karole Peters NAME: Ewing -Leavitt Insurance Agency, Inc. PHONE . (970) 679-7355 JFa, No: (866)237-2178 4090 Clydesdale Parkway AIL ADDRESS: karole-peters@leavitt.com Suite 101 INSURERS AFFORDING COVERAGE NAIC # _ Loveland CO 80538 INSURERA:United Fire & Casualty 13021 INSURED INSURER B :Pinnacol Assurance 41190 Thunderpup Construction Inc -INSURER C:Travelers Insurance Companies A19046 1520 E. Mulberry Street INSURERD: Suite 200 -INSURER E: Fort Collins CO 80524 INSURERF: COVERAGES CFRTIFICATF NI IMRFP-19-20 UFG RFVICIrIAI Kit ItURGD 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 SUBR POLICY NUMBER POLICY EFF POLICY EXP - LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR 60489048 3/30/2019 3/30/2020 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence 300 000 $ � X MEDEXP(Any oneperson) $ 5,000 Blkt Additional Insured X Blkt Waiver of Subro PERSONAL SADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY � JE C LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY 60489048 3/30/2019 3/30/2020 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS P INJURY BODILY INJUer accident ( ) $ X PROPERTY DAMAGE P acciden $ X NON -OWNED HIRED AUTOS AUTOS(per X $ Bkt At X Blkt WOS A X UMBRELLA LIAB X OCCUR 60489048 3/30/2019 3/30/2020 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 EXCESS LIAB CLAIMS -MADE DED I X RETENTION 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? NIA A 4066677 Blanket Waiver of 3/l/2019 3/l/2020 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYE $ 500 , 000 -- - (Mandatory in NH) If yes, describe under Subrogation -- DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 C Builders Risk- Open Report QT-660-8F330316-TIL-19 1/9/2019 1/9/2020 Frame Const w $1000 ded $1 , 500 , 000 A Leased/Rented Equipment 60489048 3/30/2019 3/30/2020 Limit with $500 ded $100,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins Parking Services is named additional insured on the General Liability as regards work performed by the insured. \.CR I Iri,,A I r- rIVLUr-M GANGtLLA I IUN City of Fort Collins Parking Services 215 N. Mason Street 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 role Peters/KAPETE 00<4'� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD IIUgnir,i IAni�