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HomeMy WebLinkAbout150588 WALSH CONSTRUCTION INC - INSURANCE CERTIFICATE (21)OP ID: SLS Acoszo CERTIFICATE OF LIABILITY INSURANCE FD05/08/2019Y) 05/08/2019 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 endorsement(s). PRODUCER CONTACT Front Range Insurance Group PHONE FAX 2002 Caribou Drive, Ste. 101 A/c No Ext : A/c No): Fort Collins, CO 80525 E-MAIL David A. Wooldridge LUTCFAAI PRODUCER r-ticTnMFR in e• 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 : Bltco General Insurance Corp Loveland, CO 80537 INSURER C : Western World Insurance Group INSURER D : INSURER E : INSURER F : COVERAGES CFRTIFICATF NIIMRFR• RFVIRIr1N NI IMRFR- 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 A L', UBR POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM/DD/YYYY LIMITS B C B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FRI OCCUR X Pollution Liab X �' CLP 3 670 670 AHSECC12316-00 CLP 3 670 670 07/01/2018 09/22/2018 07/01/2018 07/01/2019 09/22/2019 07/01/2019 EACH OCCURRENCE $ 1,000,000 A TO RENTE11— PREMISES Ea occurrence $ 300,00 MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,00 X RailRoad Liab GENERAL AGGREGATE $ 2,000,00 GEN'LAGGREGATE LIMIT APPLIES PER . POLICY X PRO LOC PRODUCTS- COMP/OP AGG $ 2,000,00 Poll Liab $ 1,000,00 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS CAP 3 670 671 CAP 3 670 671 CAP 3 670 671 CAP 3 670 671 07/01/2018 07/01/2018 07/01/2018 07/01/2018 07/01/2019 07/01/2019 07/01/2019 07/01/2019 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ PROPERTY DAMAGE (PER ACCIDENT) $ X X Comp Deduct $ 50 Coll Deduct $ 50 B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CUP 2 814 437 07/01/2018 07/01/2019 EACH OCCURRENCE $ 3,000,00 AGGREGATE $ 3,000,00 DEDUCTIBLE RETENTION S $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEY/N OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below .1A 4104361 05/01/2019 05/01/2020 WC STATU- OTH- TORY LIMITS X ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,00 B Contractors Equip CLP 3 670 670 07/01/2018 07/01/2019 linst Floa 353,00 Leas/Rent 250,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Fort Collins is named as additional insured with respects to General Liability policy. Protect: Fort Collins -Loveland Municipal Airport Snow Removal Equipment (SW Building t, l I II 11,A 1 t HL)LUtK t.:ANL 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. 215 N Mason Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD