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HomeMy WebLinkAboutECI SITE CONSTRUCTION MANAGEMENT INC - INSURANCE CERTIFICATE (3)A4..s-/RD _ _ DATE(MM/OD/YYYY) � CERTIFICATE OF LIABILITY INSURANCE 6126/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIOW ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. ?HIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELYAMEND, EXTEND. OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORI2ED 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. this`certificate does not confer rights to the certificate h lder in Ileu of s e policy,: certain policies may require an endorsement. A`statement on If SUBROGATION IS WAIVED, subject to the terms and conditions of th 9 d such endorsements). PRODUCER NAMEA IMA Denver Team: IMA, Inc. -Colorado Division PHone 303-539 4567 .. _...._ _____. FAX, Ho 1705'17th Street, Suite 100 E-MAIL - Denver CO 80202 DRESS: DenAccountTechs@imacorp.com Site Construction Management, Inc. i 14th Street SE stand CO 80537 COVFRAr.FS CFRTIFV`ATC MI IRSRCR• Inns AnoAza nte(ncinu au uaneo. 20095 19046 20109 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 ISSUEDOR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN iS SUBJECT TO 'ALL THE TERMS, EXCLUSIONS AND CONDITIONS OFSUCH POLICIES. LIMITSSHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - ___Bq. .: ._ .. INSR 'LTR TYPEOFINSURANCE ADD D POLICYNUMBER ._ POLICY EFF MWODNY: - POLICY EXP. MM0)YEX _.- LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FXI OCCUR CLP3695370 711/2020 71,112021 .EACH OCCURRENCE $1,000,000 PREMISES (Ea'acairrenceP $50,000 X MED.EXP Anyone rson) $5,000 PO.Ded:$2,000 PERSONAL B.ADV.INJURY $,1,000,060 GEML AGGREGATE LIMIT APPLIES PER:. POLICY J COT LOC GENERAL AGGREGATE 57,000,000 - PRODUCTS -COMP/OPAGG $2,000,000 $. OTHER: A AUTOMOBILE LIABILITY CAP3695371 - 7/1/2020 - 7/1/2021 COMBINED SINGLE 11M1T Ea accxi 51-,000,000 x BODILY INJURY (Per person) _ $, ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILYINJURY (Per accident) $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE - Per. accident: S $ B X IOCCUR UMBRELLA UAB . X ZUP61 990$A20NF 7/1/2020 71112021 E/iCHOCCURRENCE $4,000;000 I EXCESS UAB CLAIMS -MADE AGGREGATE $4,000,000 DED. I X I:RETENTION $ _ . - $ . __ A_ WORKERS AND EMPPLOYERSFUAB1UiY YIN SATIONWC3fi9 ANYPROPRIET6ivPARTNER!EXECUTIVE N OFFICER/MEMBEREXCLUDED? NIA 372 - 7!1/2020 71112021 X STATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYE S1;000,000 (Mandatory .In.NH) It describe under yyas,SC DERIPTION OF OPERATIONS below - E.L. DISEASE. POLICY LIMIT - $1,000,0011 C Excess Second Layer Liability CUP28 8003 7/1/2020 7/1/2021 Each Occurrence $1,000,000 Aggregate. $1,000,000 DESCRIPTioN OF OPERATIONS / LOCATIoms/ VEHICLES (ACORD 101i Additional Certificate Holder is included as Additional Insured on the General, with respect to work performed by Insured subject to the poli the General, Automobile, Umbrella and Workers Compensa by Insured subject to the policy terms and conditions. This Insurance and conditions. Remarks Schedule; maybe attached if more space, Is required) Automobile and Umbrella Liability Policies if required by written contractor agreement and y terms an and conditions. A Waiver of Subrogation is provided in favor of Certificate Holder on n Liability Policies if required by written contract or agreement and with respect to work performed is Primary and Non -Contributory on the General Liability Policy subject So the policy terms See Attached... w: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE poudY PROVISIONS: PO Box 580 Fort Collins CO 80522 AUTHORIZED REPRESENTATIVE USA l J d 01988-2015 ACORD ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 4• of 5 n96 AGENCY CUSTOMER ID: SF0000059586 LOC M: �o ADDITIONAL REMARKS SCHEDULE Y - NAMED INSURED Inc. - Colorado Division ECI Site Construction Management, Inc. 2526 14th- Street .SE NUMBER Loveland CO.80537 ADDITIONAL REMARKS FORM 1S A SCHEDULE TO A A AIIIAARFR• 25 cneM TITI a- CERTIFICATE Any NAIC CODE DATE FORM, iBILITY INSURANCE ry Co. of America. DO Deductible Page 1 of t The ACORD and logo are registered marks of ACORD reserved. 5' of 5 3896