HomeMy WebLinkAboutADVANCED UNDERGROUND INC - INSURANCE CERTIFICATE (6)CERTIFICA'
OF LIABILITY INSURANCE DATE("IVDD"YYY)
6/30/2020
THIS CERTIFICATE IS ISSUED AS A MATTER OF
CERTIFICATE DOES NOT AFFIRMATIVELY OR: N
BELOW. THIS CERTIFICATE OF INSURANCE DI
ATION'-ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
LY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
'CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),, AUTHORIZED
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(fes) must have ADDITIONAL INSURED progisions or be endorsed.
It 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 rights to the certificate holder in lieu of such endo►sement(s).
PRODUCER CONTACT
NAME: Shana Tama o
Commercial Risk Solutions PHONE 303.996-7842 ..,. _ aco:303757-7719
6600 E. Hampden Ave., Ste. Z00 E-MAIL
Denver CO 80224 ADDRESS: stama o crsdenver:com
INSURED
Advanced -Underground, Inc.
Frontier Underground, LLC
P.O. Box 1063
Brighton CO 80601
COVERAGES CERTIFICATE 14UMBER:1356839730 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSUI
RANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS;
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN
a
MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
I .. _ _. TYPE OPINSURANCE _.
A
N O
SUER
WVD
- ...POLICY
NUMBER. .._
POU��YY EFF
MMIDDIY.Y..
ppppLICY EXP
MM1DDlYYY
.LIMITS
e
X
CONMEIiCIALGENERALLIABILITY
Y
DTC09P485688COF20
7/1=20
711/2021
FACHOCCURRENCE .
$1'.000100D'
CLAIMS -MADE FTIOCCUR
PREMISESEaoearrrenee
$500,000
MED EXP (Any one arson)
$ 5,000
PERSONAL& ADV INJURY
$ 1,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE. ..
$2,000,000
..
POLICY � JET LOC
PRODUCTS -COMPIOPAGG
$2,000,000 '
_ _
_$ ..
OTHER: ...
I ..
I ...I
I
I . . _
C
AUTOMOBILELIABILITY
-
.8109P49209
02026G
7/1/2020
711l2021
COMBINED SINGLE LIMIT
Es acrJdent
$1,000,000
X
BODILY INJURY (Per person),
$
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
$
X
PROPERTY DAMAGE
Peracciderd
$
HIRED N NON -OWNED
AUTOS ONLY AUTOS ONLY
$
_.
D
X
-
11MBRFJJ.ALIAI3
X
OCCUR
CUP9P4B49862026
-
7112020
711/2021
_
EACH OCCURRENCE
.
$8,000.000
AGGREGATE
$5,000,000
EXCESS LIAB
CLAIMS -MADE
I DED I X I RETENTION$
$
A
WORKERSCOMPENSATION-
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETORIPARTNERlEXECUTIVE
OFFICEMMEMSER EXCLUDED?
NIA
4076345
11.112020
111/2021
X. STATUTE ER.
E.L. EACH ACCIDENT
$1,000,000
-
(Mandatory In NH)
E.L. DISEASE- EA EMPLOYEE
$1 000,000
It yyes; describe under
0ESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$1�000,000
D
Intend Marine
4H595996
7/1/2020
7/1/2021
Schd1 EEj%qupmem
Leased/R6nted Eoulp
Ded
963,200
100.000
1;000
DESCRIPTION OF OPERATIONS I LOCATIONS! VEHICLES IACORD 101, Additional
Remarks Schedule, may. be-atleched H more spede Is *utred)
City of Fort Collins is included as additional insured on the General
required.by written contract. All policy terms, conditions and exclusions
Liability With respect to ongoing operations of the named insured for the certificate holder as
apply.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE I EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Fort Collins
PO Box 580 AUTHORIZED REPRESENTA
Fort Collins CO 80522
1�5
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
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