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HomeMy WebLinkAbout391229 SITEWISE LLC - INSURANCE CERTIFICATE (3)Client#: 1483410 PEAKUTI ACORD CERTIFICATE OF LIABILITY INSURANCE D9/27/2I01DD9YYYI /27/2 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 CONTACT Client Manager _ _ USI Insurance Services, LLC PHONE g00 873$500 303-831-5295 AIC No Eat): A/C, No P.O. Box 7050 A DRESS, den.contractors@usi.com Englewood, CO 80155 INSURER(S) AFFORDING COVERAGE NAIC A 800 873-8500 INSURER A: Arch Insurance Company 111150 INSURED Sitewise, LLC 4725 Independence St., Suite 100 Wheat Ridge, CO 80033 INSURER B : Allied worm Specialty Iesummee Camp" 116624 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. TL RR TYPE OF INSURANCE AODL SUB POLICY NUMBER MM%DDY� MMIDDY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X X ZAGLB9220703 10/01/2019 10/01/202C EACH OCCURRENCE $5000000 PR nte DEMISES ERENTED $100 000 MED EXP (Any one person) $10,000 PERSONAL 8 ADV INJURY $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRO- X POLICY O JECt' 71 LOC OTHER: GENERAL AGGREGATE $5,000,000 PRODUCTS - COMP/OP AGG $5,000,000 $ A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED ONLY X NON-0WNED AUTOS ONLY X X ZACAT9242603 10/01/2019 10/01/202 (Es accident SINGLE LIMIT 5,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ B UMBRELLA LIAR EXCESS LJAB OCCUR CLAIMS -MADE X X 03115397 10/01/2019 10/01/202 EACH OCCURRENCE s7,000,000 N AGGREGATE s7,000,000 DED RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? F_N1 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA X ZAWC19401303 10/01/2019 10l01/202 X PER OTH- E.L. EACH ACCIDENT $S 00O 000 E.L. DISEASE -EA EMPLOYEE $5,000,000 E.L. DISEASE -POLICY LIMIT $5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACCORD 101, Additional Remarks Schedule, may be attached if more space is required) The General Liability policy includes an automatic Additional Insured endorsement that provides Additional Insured status to City of Fort Collins, only when there is a written contract that requires such status, and only with regard to work performed on behalf of the named insured. City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O. BOX 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522-0580 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 Of 1 The ACORD name and logo are registered marks of ACORD #S26718150/M26672741 KYGZP