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HomeMy WebLinkAbout224601 THOUTT BROS CONCRETE CONTRACTORS INC - INSURANCE CERTIFICATE (2)CERTIFICA OF LIABILITY INSURANCE DATE 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 WANED, subject to the terms and conditions of the policy, certain policies may require. an endorsement A statement on this certificate does not confer riahts to the certificate holder in lieu of such endoreement(s). PRODUCER Pinnacol Assurance 7501 E. Lowry Blvd. Denver, CO 80230-7006 A: Thoutt Bros Concrete Contractors Inc 5460 Tennyson St Denver, CO 80212 Assurance COVERAGES CERTIFICATE NUMBEk 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 WITHRESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE , BY THE POLICIES DESCRIBED HEREIN IS, SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HE BEEN REDUCED BY PAID CLAIMS. - HAVE LTR LTR TYPE OF INSURANCE �UCYNUMBER MMA)D EFF MM/DDNYY LIMITS COMMERCUILGENERALLUIBILITY EACH OCCURRENCE _ -- - -- $ CMS -MADE a;OCCUR W i - DAMAO RMMD PREMISES (Ea occurrence) $ MED EXP(Any one person) $ 7 PERSONAL& ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ POLICY ❑ PECTr7 LOC PRODUCTS - COMP/OP AGG $ $ 'OTHER: •.I AUTOMOBILE LIABILITY - ., _ COMBINED SIG I accident. . BODILY INJURY (Per person) ..._. S ANY AUTO OWNED I 7. SCHEDULED I' �'..'. ... ' BODILY INJURY (Per a'cciden $ AUTOS ONLY AUTOS PROPERTY DAMAGE. accident)_ $ HIRED NON N AUTOS ONLY, AUTOS ONLY �I - ,.(Per UMBRELLA LIAO OCCUR EACH OCCURRENCE t AGGREGATE $ EXCESS UAS CLAIMS -MADE DED RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' UABIUTY IN ANYPROPPJETOR/PARTNER/EXECLrriVE Y❑ OFFICER/MEMBEREXCLUDED9 (Mandatory In NH) N/A - 2033000 11/01/2019 11/01/2020 PER X I STATUTE I ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOY $ 1-,000,000 If yes describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Unless otherwise stated in the policy provisions, coverage in Colorado Remarks Schedule, may be attached it more space is required) only. Refer to the Acord 101 Additional Remarks Schedule for supplemental cancellation notification information. CERTIFICATE HOLDER I CANCELLATION 2032870 City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO Box 580 THE EXPIRATION DATETHEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522-0580 AUTHOROM REPRESENTATIVE PlnnacolAssurance ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD nartje and logo are registered marks of ACORD ACORDs provided by Forms mossi. www.FonnsBoss.com; (c) Impressive Publishing 860-208-1977 Additional Insured Copy C 0 POLICY NUMBER: 9030364 THIS ENDORSEMENT ADDITIONAL INSU COMMERCIAL GENERAL LIABILITY CG 20 12 04 13 ;ES THE POLICY. PLEASE READ IT CAREFULLY. ED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COERAGE PART SCHEDULE State Or Governmental Agency Or Subdivi on Or Political Subdivision: CITY OF FORT COLLINS P O BOX 580 FORT COLLINS CO 80522 Information required to complete this Schedule, if not shown above,. will be shown in the Declarations. A. Section 11 Who Is An Insured is a include as an additional insured an governmental agency or subdivision subdivision shown in the Schedule, sul following provisions: 1. This 'insurance applies only with operations performed by you o behalf for which the state or go agency or subdivision or political has issued a permit or authorizatioi However: a. The insurance afforeded to sucl insured only applies to I permitted bylaw; and b. If coverage provided to the insured is required by a c agreement, the insurance affon additional insured will not be bi that which you are require contract or agreement to provi4 additional insured. TITAN ELECTRIC COMPANY 4954 WARD RD WHEAT RIDGE CO 80033 fended to 2. This insurance does not apply to: state or a. 'Bodily injury," "property damage" or r political "personal and advertising injury" arising ect to the out of operations performed for the federal goverriment, state or municipality; or •espect to b. 'Bodily injury" or "property damage" on your included within the "products -completed ernmental operations hazard". ubdivision B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: additional If coverage provided to the additional insured is e extent required by a contract or agreement, the most we will pay on behalf of the additional insured is the additional amount of insurance: intract or 1.. Required by the contract or agreement; or such faar than )ade 2. Available under the applicable Limits of I by the Insurance shown in the Declarations; __ for such whichever is less. This endorsement shall not increase the applicable limits of Insurance shown in the Declarations. 19.Te*Z115 P411.191 © In: Policy N Services Office, Inc., 2012 Page 1 of 1 9030364 Transaction Effective Date: 01-01-2020