HomeMy WebLinkAbout184254 DURAN EXCAVATING INC - INSURANCE CERTIFICATE (7)A4CC3I1?Or CERTIFICATE OF LIABILITY INSURANCE
DATE(t.1N40D/VVYY)
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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 endorsements .
PRODUCER
FEDERATED MUTUAL INSURANCE COMPANY
HOME OFFICE: P.O. BOX 328
CONTACT
NAME, CLIENT CONTACT CENTER
A C, . E,n : 888-333-4949 Fa c No): 507-448-4664
ADDRESS: CLIENTCONTACTCENTER FEDINS.COM
OWATONNA, MN 55060
_ INSURER(SI AFFORDING COVERAGE
NAIL t%
INSURER A: FEDERATED MUTUAL INSURANCE COMPANY
13935
INSURED 397-432-6
INSURER e: FEDERATED SERVICE INSURANCE COMPANY
28304
DURAN EXCAVATING INC
14332 COUNTY ROAD 64
INSURER C:
INSURER D:
GREELEY, CO 80631-9317
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 44 REVISION NUMBER: 2
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
INSR
SUER
WVD
POLICY NUMBER
POLICY EFF
MMfDD/VYVY
POLICY EXP
MM/DD/YYYy
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$1,000,000
CLAIMS -MADE ❑X OCCUR
DAMAGE TO RENTED
PREMISES Ea occurrence
$IOO,000
MED EXP (Any one person)
EXCLUDED
A
Y
N
9911663
01/01/2019
01/01/2020
PERSONAL& ADV INJURY
$1,000,000
GEI
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$2,000,000
PRODUCTS - COMPIOP AGO
$2,000,000
X
POLICY ❑ IECTPi [ -I LOC
OTHER:
AUTOMOBILE
X
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
We accident
$1,000,000
BODILY INJURY (Per person)
A
OWNED AUTOS ONLY AUTOSU�D
N
N
9911663
01/01/2019
01/01/2020
BODILY INJURY (Per accident)
HIRED AUTOS ONLY NON -OWNED
AUTOS ONLY
PROPERTY DAMAGE
Per accident
X
UMBRELLA LAB
X
OCCUR
EACH OCCURRENCE
$10,000,000
A
EXCESS LIAB
CLAIMS -MADE
N
N
9911666
01/01/2019
01/01/2020
AGGREGATE
$10,000,000
DED I I RETENTION
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y/N
ANY PROPRIETORIPARTNERIEXECUTIVE
B 'OFFICER/MEMBER EXCLUDED? 17NIA
N
9911667
01/01/2019
01/01/2020
X PER STATUTE OTH
ER
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA EMPLOYEE
$1,000,000
(Mandatory in NH)
If yes, desenbe under
DESCRIPTION OF OPERATIONS below
E.L DISEASE - POLICY LIMIT
$1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached it more space is required)
RE: STRUCTURAL CONCRETE ENDORSEMENT CONTRACTORS LICENSE
CERTIFICATE HOLDER IS ADDITIONAL INSURED FOR GENERAL LIABILITY.
CERTIFICATE HOLDER CANCELLATION
397-432-6
CITY OF FORT COLONS
PO BOX 580
FORT COLLINS. CO 80522-0580
442
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
O 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD