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HomeMy WebLinkAbout592927 HASELDEN CONSTRUCTION LLC - INSURANCE CERTIFICATE (8)I<fi1111MMi_ 1 ® DATE (MMIDONYYY) ACORO CERTIFICATE OF LIABILITY INSURANCE 09/30/2019 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 u 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. N 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 1-303-534-4567 INA, Inc. - Colorado Division CONTACT N PHONE FAX 1705 17th St Ste 100 >N> uJ L�U1 ADDRESS: denaccounttechagimalCorp.com INSURERS AFFORDING COVERAGE NAIC0 INSURER A: VALI+Jly FOR= INS CO (wDU 20508 Denver, CO 80202 INSURED INSURERS: RATIONAL FIRM 1185 CO OF RARTFORD(CNA) 20478 Haselden Construction, LLC INSURERC: CONTIR®T1'AL IRS CO (CHID) 35289 INSURERD: P'MWLCOL ASSOR 41190 6950 South Potomac Street INSURER III: INSURERF: Centennial, CO 80112 r:flVFOAPFC f-01MFII`AT9 MIIYRFD• 57428236 DOWAInm M11YRF0• 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. law TYPE OF IN POLICYNUYSER POLICY EFF POLICY EXP 1H111,8 A Z COMMERCIAL GENERAL LIABILITY 4028808411 07/01/19 07/01/20 EACH OCCURRENCE S 1,000,000 CLAIMS-MADE F-11 OCCUR DAMAGE TO RENTIff— PREMISES (Ea S 1,000,000 Z MED EXP (Anyone Person) $ 15,000 PD Ded: $10, 000 PERSONAL 4 ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY � JECT PE LOC PRODUCTS-COMP/OP AGO S 2,000,000 4 OTHER: B AUTOMMIEUABILm C4028808425 07/01/19 07/01/20 COMBINED tSINGLE LIMIT $ 1,000,000 BODILY INJURY Per Person) $ Z ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Far accident) S PROPERTYDAMAGE Itl $ Z HIRED Z NON -OWNED AUTOS ONLY AUTOS ONLY s C Z UMBRELLA LIAR X OCCUR 6042783626 07/01/19 07/01/20 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAR CLAIMS -MADE DED X I RETENTIONS 10,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDED4 (Mandatory In NH) MIA 4082635 - CO ONLY 07/01/19 07/01/20 PEAT TE ERK X I E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 n yea describe under DESCRIPTION OF OPERATIONS balm E.L. DISEASE - POLICY LIMIT f 1, 000, 000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACCIRD 101, Addlaonal Remarks Schedule, may be attached Itmore spece Is required) City of Fort Collins is included as Additional Insured on the General, Automobile and Umbrella Liability Policies if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. A Waiver of Subrogation is provided in favor of Additional Insured on the General, Automobile, Umbrella Liability and Workers Compensation Policies if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 7ity of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Box 580 r RIZED REPRESENTATIVE t Collins, CO 80522 /// USA L ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD eadie55 57428236