Loading...
HomeMy WebLinkAbout150588 WALSH CONSTRUCTION INC - INSURANCE CERTIFICATE (19)OP ID: SLS ACORO CERTIFICATE OF LIABILITY INSURANCE D0 /08/2019 Y) 0510812019 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 endorsement(s). PRODUCER CONTACT Front Range Insurance Group PHONE FAX 2002 Caribou Drive, Ste. 101 A/c No EXt : Iwe No): Fort Collins, CO 80525 E-MAIL David A. Wooldridge LUTCFAAI PRODUCER ri iernuco in u- WALSH-4 _ INSURER(S) AFFORDING COVERAGE _ NAIC # INSURED Walsh Construction, Inc. INSURER A:Pinnacol Assurance 41190 Matthew Walsh, Pres. 8139 Open View Place INSURER B : Bitco General Insurance Corp Loveland, CO 80537 INSURER C :Western World Insurance Group INSURER D : INSURER E : INSURER F : 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. INSR LTR TYPE OF INSURANCE ADDL' UBR POLICY NUMBER POLICY EFF IMMIDDIYYYYI POLICY EXP [MMIDDIYYYY)LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00( PREMISES Ea occurrence $ 300,00 B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X �CLP 3 670 670 07/01/2018 07/01/2019 MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,00 C X Pollution Liab ,AHSECC12316-00 09/22/2018 09/22/2019 X RailRoad Liab GENERAL AGGREGATE $ 2,000,00 B CLP 3 670 670 07/01/2018 07/01/2019 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP_/OP AGG $ 2,000,00 POLICY X PRO LOC Poll Liab $ 1,000,00 B AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS CAP 3 670 671 CAP 3 670 671 07/01/2018 07/01/2018 07/01/2019 07/01/2019 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ SCHEDULED AUTOS HIRED AUTOS CAP 3 670 671 07101/2018 07/01/2019 PROPERTY DAMAGE (PER ACCIDENT) $ X NON-OWNEDAUTOS CAP 3 670 671 07/01/2018 07/01/2019 X Comp Deduct $ 50 Coll Deduct $ 50 I J( UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,00 AGGREGATE $ 3,000,00 B EXCESS LIAB CLAIMS -MADE CUP 2 814 437 07/01/2018 07/01/2019 DEDUCTIBLE $ $ RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITYER ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N / A 4104361 05/01/2019 05/01/2020 DRY LIMITS X T E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,00 B Contractors Equip 3 670 670 07/01/2018 07/01/2019 Inst Floa 353,00 �CLP Leas/Rent 250,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Ft. Collins is listed as an Additional Insured with regards to the General Liability policy on ongoing and completed projects L.tK I ll-lt A I t MULUtK L ANk tLLA I IUN CITYOFF 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 P.O. Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD