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HomeMy WebLinkAbout103166 ZAK DIRT - INSURANCE CERTIFICATE (3)Client#: 38185 ZAKDIRPC ACORD- CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) 1 4/26/2019 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER Holmes Murphy - Colorado 7600 East Orchard Road, Suite 230 South Greenwood Village, CO 80111 CONTACT NAME: Nick Brown PHONE 720-458-5770 FAX 844-248-0468 A/C No Ezt : A/C, No E-MAIL nbrown holmesmur h ADDRESS: P ycom INSURERS) AFFORDING COVERAGE NAIC / INSURER A: Zurich American Insurance Company 16535 INSURED INSURER B : Travelers Casualty Insurance Co of Amer 19046 Zak Dirt, Inc. Allianz Global Corporate & Specialty AG INSURER C : P P tY 03887 14290 Hilltop Road Longmont, CO 80504 Indian Harbor Insurance Company INSURER D : P Y 36940 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 CONTRACTOR 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 ADDLSUBR INSR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDD/YYW LIMITS A X COMMERCIAL GENERAL LIABILITY X GL0485843203 5/01/2019 05/0112020 EACH OCCURRENCE $1 000000 CLAIMS -MADE � OCCUR PREMISESa oNcur ence s500,000 X MED EXP (Any one person) $10,000 BI Ded: $2,500 PERSONAL BADVINJURY $1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER : GENERAL AGGREGATE $2,000,000 PRO - POLICY X JECT X LOC PRODUCTS - COMP/OPAGG $2,000,000 $ OTHER: A AUTOMOBILE LIABILITY BAP485843303 5/01/2019 05/01/202 Ea a."eDtSINGLE LIMIT $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY PROPERTY DAMAGE Per accident $ $ X Drive Oth Car B UMBRELLA LIAR X OCCUR ZUP91 M6242919NF 5/01/2019 05/01/202 EACH OCCURRENCE s5,000,000 X AGGREGATE $5 000 000 EXCESS LIAR CLAIMS -MADE DED I X I RETENTION $1 O 000 $ A IONILIT VVOAND EMPLOYERS' YERS'LIABILITY AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBEREXCLUDED? NI (Mandatory in NH) N/A WC485843103 5/01/2019 05/01/202 X PER OTH- E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1 000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below I C Leased/Rented Eq. SML93080423 5/01/2019 05/01/202 $1,000,000; $1,000 Ded C Installation Fit. SML93080423 5/01/2019 05/01/202 $250,000; $1,000 Ded D Pollution/Profess PECO04987502 5/01/2019 05/01/202 $1,000,000; $25,000 Ded DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: N College Improvements City of Fort Collins and Colorado Department of Transportation are included as additional insureds as respects the General Liability, as required by written contract, per the policy terms and conditions. CERTIFICATE City of Fort Collins Purchasing Division PO Box 580 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 ACORD 25 (2016/03) 1 of 1 #S442694/M442682 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MANV1