HomeMy WebLinkAboutHEATH CONSTRUCTION LLC - INSURANCE CERTIFICATE (2)P52 2M2
ACCM0 CERTIFICATE OF LIABILITY INSURANCE
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THIS CERTIFICATE it ISSUED AS -A NATTER 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, fhe poiicy(les) must have ADDITIONAL INSURED provisions or be endorsed.
N SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this eerti ieate does not confer rights to the certificate holder in lieu of such endorseme s .
PRODUCER 1-303-534-4567
nIA, Inc. - Colorado Division
1705 17th 8t Ste 100
Denver, CO 60202
CONTACT -
NAME:
PHONE FAX
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INSURER(S)AFFORDING COVERAGE
-
NAIL/
INSURERA: HARTFORD FIRE IN CO
19682
INSURED
Heath Construction, LLC dba. Saundere8eatb
1212 Riverside Avenue, Suite 130
Fort Collins, CO e0524_
oamma: TRUMBULL INS CO (Hartford Insurance CO)
27120
uNsuREa c ENDURANCE JUNIORINS CO
10641
INSURER e: PINNACOL AHSOR
41190
INSURER E :
INSURER F:
rnveoer_Ca BCDTICICATC MIHMR9D-S7528817 RFVISinN NUNRFR-
THIS IS TO CERTIFYTHAT 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.
...
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TYPE OF D6URANCEAUUL
ppLltY NUMBER
POLICY EFF
POLICY EWLTR
lame
A
Z_
WIDIERCIALOEr03GLLIAB1UIY
CLAMS -MADE � OCCUR
$5.000 PD Deductible
34URRZT7859
04/30/19
04/30/20
EACHoccURRENCE
000,000
PREMISES e
000
Z
MED EXP one
E$300,
,000
PERSONAL 4 AOV INJURY
000,000
GENLAGGREGATE UMR APPLIES PER
POLICY�,PRO� El LOC
OTHER:
GENERAL AGGREGATE
000,000
PRODUCTS-COMPIOP.AGG
S 2,000,000
s
H
AuTTONOBaE
IZ ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
Z HIRED Z NON-0NMm
AUTOS ONLY AUTOS ONLY
34DZAZT7860
04/30/19
04/30/20
COMBINED SINGLE UM fEa
F 1,000,000
BODILY INJURY(PK Pavan)
i
BODILY INJURY (Pw eamal)
S
PROPERTY.�AMAOE
s
s
C
X
UI®BELl Ai
EXCESS t_uB
Z
OCCUR
CLAIMS -MADE
XSC30000649201
04/30/19
04/30/20
EACH OCCURRENCE
S 10,000,000
AGGREGATE
$ 10,000,000
DED
RETENTION III
_ _ _
1
D
AND EMPLOYERS' L1 B�rtY
ANYPROPRIETORIPARTNE (EXECUTIVE O
OFR ERA®YBERE%CLUDED?
(YuWtOorybNlq-
I 4eaies -Aw
DEST TIM7f70p OF OPERATIONS bebr
NIA
3096125 - Colorado
10/01/19
10/01/20
Z siATuTE ®
El. EACH ACCIDENT'
$ 1,000,000
El. DISEASE -EA EMPLOYEE
$ 1,000,000
El. DISEASE - POLICY LIMIT
S 1,000,000
OEeCNP11DN OF OPERA7ION6I LOCATIONS VBtlCIEb (ACORD 101, AAaIIaW Rsmerkv SeM4aN, may he et4Uied N nqn/ Wep M ipulneo
City of Fort Collins, Admin Services Purchasing Division are included as Additional Insureds On the General Liability
Policy if required by written contract or agreementand with respect to Mork performed by Insured subject to the policy
terms and conditions.
ecovICN`ATC urn nco CANCFI I ATInm
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins
Admix Services Purchasing Division
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box: 580
AU_THORREOR_EPRESENTATNE
Fort Collins, CO 00522-0580
USA
1V TSae-ZU'ta AwuHN I;unrurwn nun. Pal ngms reserveo.
ACORD 25 (2016f03) The ACORD name and logo are registered marks of ACORD
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S7528817