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HomeMy WebLinkAbout132158 CTL/THOMPSON INC - INSURANCE CERTIFICATE (24)r..TI THC) ACORD. CERTIFICATE OF LIABILITY INSURANCE D9 'MIN/DD/VVVY) 9/26/2019 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(les) 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 i CO NTACT NAME:: PNHCN o Eat:800873-8500 AIC,N,: USI Insurance Services, LLC E-MAIL ADDRESS: P.O. Box 7050 Englewood, CO 80155 INSURERS) AFFORDING COVERAGE NAIC# INSURER A: TrmNn Property w.. co. m AmMu 25674 800 873-8500 INSURED CTL/Thompson, Inc. INSURER B : Pin^aeel Auuranoe Company 41190 pin INSURER snrrSi in Linn lnsuramo,Company 13604 : Sim S. Alton Way INSURER D Charter Oak FlnInsurance Company 25615 Centennial, CO 80112 INSURER E: — INSURER F : rnvoo nr_oc rl❑aTlFlreTc NI IknRFR• 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 POLICY EXP (MMDD1Y /YYY) .(MMIDDNYY LIMITS A X COMMERCIAL GENERAL LIABILITY X X 6806H199682 0/01/2019 10/01/202C EEAACCH�GOECCTURRENCE $1 000000 TED PREMISES Ea occurrence $1 000 000 CLAIMS -MADE 51OCCUR Mm EXP (Any one person) $10 000 PERSONAL &ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000 000 PRODUCTS -COMPIOP AGG $2,000,000 POLICY FXJ JEOTCLOC i $ OTHER: D _ AUTOMOBILE LIABILITY X X 8101175R522 0/01/20191i10/01/20 MBINED EaaacciderrtSINGLELIMR 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Par accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS X AUTOS ONLY X HIRED NOWOWNED AUTOS ONLY PROPPEtt tlTVnDAMAGE (Per $ $ A X1 UMBRELLALIAB X I OCCUR X X CUP3CO02974 0/01/2019 10/01/2020 EACHOCCURRENCE $6000000 AGGREGATE $$ 000 000 EXCESS LIAB CLAIMS -MADE DED X RETENTION $10000 Is _ I B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOWPARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? � (Mandatory In Ni NIA X 180512 0/01/2019 10/01/2020 X I STATUTE rp OTH- - E.L. EACH ACCIDENT $500000 - $500000 E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $500 000 $2,000,000 per claim If yyae, IPTIOe under DESCRIPTION OF OPERATIONS llalow SLSLPR026233619 10/01/2019 10/01/2020 C Professional Liab Incl. Pollution $4,000,000 annl aggr. Claims Made DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES (ACORD 101. Additional Remarks Schedule, maybe attached it more space is required) As required by written contract or written agreement, the following provisions apply subject to the policy terms. conditions, limitations and exclusions: The Certificate Holder and owner are included as Automatic Additional Insured's for ongoing and completed operations under General Liability; Designated Insured under Automobile Liability; and Additional Insureds under Umbrella / Excess Liability but only with respect to liability arising out of the Named Insured work performed on behalf of the certificate holder and owner. (See Attached Descriptions) City of Fort Collins 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 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S26675115/M26670904 P1DZP