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HomeMy WebLinkAboutWALSH CONSTRUCTION INC - INSURANCE CERTIFICATE (3)OP ID: SLS ATEACORO CERTIFICATE OF LIABILITY INSURANCE D07/24/12 V019 07I249 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 PRODUCER Front Range Insurance Group 2002 Caribou Drive, Ste. 101 Fort Collins, CO 80525 Assured Partners Colorado WALSH-4 INSURED Walsh Construction, Inc. INSURER A: Plnnacol Assurance 41190 8139 Open View Place Loveland, CO 80537 INSURER B : BHco General Insurance Corp 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 L TYPE OF INSURANCE POLICY NUMBER POLICY EFF MM/DD/YYYY1 POLICY EXP (MMIDDfYYYYI LIMITS B C GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X Pollution Liab X CLP 3 670 670 SECC12316-00 07/01/2019 09/22112018 07/01/2020 09/22/2019 EACH OCCURRENCE $ 1,000,00 PREMISES Ea oxurtence $ 300,00 MED EXP (Any one person) $ 10,0001 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER. POLICY X PRO_CT LOC PRODUCTS - COMP/OP AGG $ 2,000,0011 Pollution $ 1,000,00 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS x CAP 3 670 671 07/01/2019 07/01/2020 (OaMBBIIN D SINGLE LIMIT $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY (Per acrJdent) $ PROPERTY DAMAGE (PER ACCIDENT) $ $ $ B J( UMBRELLA LIAB EXCESS LIAR X OCCUR CLAIMS -MADE CUP 2 814437 07/01/2019 07/01/2020 EACH OCCURRENCE $ 3,000,00 AGGREGATE $ 3,000,00 DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATIONX AND EMPLOYERS' LIABILITYY A ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICERIMEMBER EXCLUDED? ❑ (Mandatory In NH) If yes describe under DESCRIPTION OF OPERATIONS below N/A X 104361 05101/2019 05/01/2020 WC STATU- OTH- LIMITS E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE S 1,000,00 - - — - $ 1,000,00 E.L. DISEASE -POLICY LIMIT B Inland Marine CLP 3 670 670 07101 /2019 0710112020 Inst Floa 350,00 Leas/Rent 250,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule. if more space Is required) As respects the City, of Fort Collins, State of Colorado, M.A. Mortenson Company and Woodward Inc subcontractor's operations on this project, the City of Fort Collins, State of tolorado, M. A. Mortenson Company and Woodward Inc are Included as additional Insureds per conditions and forms shown on page 2 CITYFC2 City of Fort Collins 300 Laporte Ave 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 © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD