HomeMy WebLinkAboutM.A. MORTENSON COMPANY - INSURANCE CERTIFICATEP526 2% 2
ACOR& CERTIFICATE OF
LIABILITY INSURANCE
oa 9i2o020
THIS CERTIFICATE IS ISSUED AS A MATTER OF A
FN INFORMATION
ON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR GATIVI
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
OLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,
B SUBROGATION IS WAIVED, subject to the terms and conditions
the pollcy(les)" must have ADDITIONAL INSURED provisions or be endorsed.
of the policy, certain policies may require an endorsement A statemerd.on
this certificate does not confer rights to the certificate holder
In lieu of such endorsements .
PRODUCER 1-908-566-1010
Construction Risk Partners
NFQNTAUT
AME: Dnrgita Bennett
PHONE Eso,484-654-0575 I- FAX No): 484-654-0590
A DRE68:.CBrteQCOnBti'I1Cti0IIriBkyartnera.COm
Campus View Plaza
INSURER(S) AFFORDING COVERAGE.
NAIC0
1250 Route 28, Suite 201
INSURERA: ARCS INS CO
11150
Branchburg, NJ 08876
INSURED
INSURER B:
M. A. MCrtenson Company
.INSURER C:.
INSURER D:
700 Neadow Lane North
INSURER E :
INSURER F:
Ninneapolis, MN 55422
COVERAGES CERTIFICATE NUMBER: U118410 REVISION NUMBER:
THIS IS TO CERTIFY THATTHEPOLICIES OF INSURANCE LISTEDI
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR
BELOW HAVE BEEN ISSUED TO THE INSURED NAMED -ABOVE FOR THE POLICY PERIOD
CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH. THIS
CERTIFICATE MAY BE.ISSUED OR.MAY PERTAIN, THE .INSURANCE
AFFORD ED_BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TOALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN
MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IN3RLm
TYPE OF IN
POLICYNUMBER
MUOYEFP
POLIC-MWDD EXP
-LIMITS
A
8
COMSUUUcALGENERALLUUNLITY
51PR08901208
05/01/20
OWD1/21
EACH OCCURRENCE
$ 2,0.00,000
CLAIMSMADE FK OCCUR
DAMAGE TO
PREMISES Eaoccurrence)
$ 2,000,000.
MEDEP (�jy one person)
$ 5,000
.PERSONAL&ADV INJURY .
s. 2,.00.0,000.
GEN'LAGGREGATE UMIT APPLIES PER:
GENERAL AGGREGATE
$ 4,000,000
PoLICY[�] PRO-
JECT ] LOC.
PRODUCTS -COMP/OPAGG
$ 4,000,000
$
OTHER:
AUTOMOBILE
LUBILITY
OMB�I SINGLE UMT
$
_LEsANYAUTO BODILY INJURY (Par person)
$
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Par accident)
$
PROPERTYDAMAGE
(Per acdd
6
HIRED -I I NON -OWNED
AUTOS ONLY AUTOS ONLY
UMBRELLA IJAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
E
EXCESS UAB
CLAIMSMADE
DED RETENTION S
$
WORKERS COMPENSATION
ANDEMPLOYERS'LNBIUfY YIN
ANYPROPRIETORIPARfNERIEXECUTNE F
OFFICERJMEMBEREXCLUDED7
NIA
-
I PER OTH-
TAT E ER-
E.L. EACH ACCIDENT
$
(Mandsbory In NH)
E.L. DISEASE - EA EMPLOYE
$
If yea desodbe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE- POLICY LIMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS VEHICLES (ACORD 701, Additlonal. _
unarks 9obWul0. may M a8aebetl N more epaoe Is npulrad)
Project ie 14060029 Project Name: Fort Collins Old
TownRight of Nay Contractors License As respects to N. A. Nortenson
Company operations on the referenced project, City
of Fort Collins is included as Additional Insured on aPrimary and
Non -Contributory basis under the General Liability
policy as regmired by written contract.. Should any of the above
described policies be cancelled before the expirat
on date thereof, the .insurers will send 30 days notice of
cancellation to the Certificate Holder (except 10
days for non-payment).
CERTIFICATE HOLDER I CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED: POLICIES BE CANCELLED BEFORE
14060029
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins
ACCORDANCE WITH THE POLICY PROVISIONS.
Raginearing Department
291 North College Ave., P. O. Box 580
AUTHORIZED REPRESENTATIVE
Fort Collins, CO 80522=0580
X�. I-u
II8A
01985.2.015 ACORD CORPORATION. All rights reServed.
ACORD 25 (2016105) The ACORD name ind logo are registered marks of ACORD
Nhuddy
59118418
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