HomeMy WebLinkAbout122685 MARTIN & SONS EXCAVATING INC - INSURANCE CERTIFICATE,moon®® CERTIFICATE OF LIABILITY INSURANCE
06/18/2020
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,
If SUBROGATION IS WAIVED, subject to the terms and conditions
this certificate does not toner rights to the certificate -_holden
the policy(ies)-must have ADDITIONAL INSURED provisions or be endorsed.
of the policy, certain policies may require an endorsement. A statement on
in lieu of such endorsement(s).
PRODUCER
Flood and Peterson
:CT ..
Shannon mmerer
NAMEKa
PHONE . (970) 356-0123 No y (970) 330 1867
ADDRESS: SKammerer®floodpeterson_corri
PO Box 578
INSURER AFFORDING COVERAGE
NAIC a
INSURER A: Cincinnati Insurance Co
.INSURER B : Pinnacol Assurance
10677
41190
Greeley CO
INSURED
80632
INSURER C.:
Mahn & Sons Excavating, Inc.
INSURER D :_
18868 Weld County Road 3
INSURER E.:
-
_ _
INSURER F:
Berthoud CO
80513
COVERAGES torn uriwki=numommi
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW
INDICATED. NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN
- -
ILTR TYPE OF INSURANCE _ POLICY
COMMERCIAL GENERAL LUIBILITY
CLAIMS -MADE OCCUR
--------
HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
MAY HAVE BEEN REDUCED BY PAID CLAIMS.
PO CY. EFF.: LI EXP LIMITS
NUMBER (MMA)MWD
.EACH000URRENCE $ 1,000,000
.PREMISES odarrenoe $ 500,000
. MED EXP (Any oneperson) $ 10,000
A EPP0258632
GEN'L AGGREGATE LIMB APPLIES PER:
v PRO- LOC
POLICY ❑/� JECT
07/01/2020 07/01/2021
PERSONAL&ADVINJURY
GENERAL AGGREGATE
PRODUCTS-.COMP/OP.AGG
$ 1,000,000
$ 2,000,000
$ 2.000,00.0
--
OTHER:
AUTOMOBILE LIABILn7
COMBSINGLE LIMIT
COMBINED
Ea aINED
$ 1,000,000
ANY AUTO
BODILY INJURY(Per person)
$
A OWNED SCHEDULED EPP0258
AUTOS ONLY - AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
32 07/01/2020 07/01/2021
a6D6ikiURY(Per accldent)
PROPERTY DAMAGE
per tlent
-
-$
$
A
UMBRELLA LIAR
1EXCESSLIAe
OCCUR
CLAIMS -MADE
EPP0258632
07/01/2020
07/01/2021
EACH OCCURRENCE
$ 2,000,000
AGGREGATE. _
$. 2.000,000
I
- -
- -
-
PER' OTH-
STATUTE .ER -
$
DED RETENTION $. 0 _
WORKERS COMPENSATION
E.LEACHACCIDENT _
$1,0
.
B
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTNE YIN
OFFICER/MEMBER EXCLUDED?
(Mandatary In NH)
it Yee, describe under
DESCRIPTION OF OPERATIONS bsim
N/A
1316630
07/01/2020
07/01/2021
E.L DISEASE -EA EMPLOYEE
.$ 1,000,000
E.L. DISEASE - POLICY LIMIT
_
$ 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD Tot, Addidonal
Remanke Schedule, may be aVaehOd H mono spece Is regWna)
CERTIFICATE HOLDER
"^ •""`^" "
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Fort Collins
PO Box 580
A671401112MD REPRESENTATIVE
Fort Collins
CO 80522-0580
LL
-- ia.. nnn nn.e annnn PneonGATInM All rinhfa rnsairved-
ACORD 25 (2916103) The ACORD name and logo are registered marks of ACORD