HomeMy WebLinkAboutFLATIRON CONSTRUCTORS INC - INSURANCE CERTIFICATE (2)Client#: 337 FLATINTERMTN
ACORD. CERTIFICATE OF LIABILITY INSURANCE °0611612020
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 NOTjCONSTITUTE 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 be endorsed. If SUBROGATION IS WAIVED; subject to
the terms and conditions of the policy, certain policies my
require an endorsement. A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsement(s).
CT
PRODUCER NAME: TSIB Inc.
Turner Surety & Ins. Brokerage PRONE 201 267-7500 201-267-7532
AIC'No Eat): (AIC, No : .
Mack Cali Centre II ADDRESS, flatironcerts@tsibinc.com
650 From Road, Suite 295
INSURE S AFFORDING COVERAGE NAICtl
Paramus, NJ 07652 INSURER A:ZurkhamericanlnsumceCoapeny -ZUR 16535
INSURED INSURER B : AIIW VJMW Assura,w Co 10690
Flatiron Constructors, Inc. INSURERC: Berkl.yI'ii' oeeanryny 32603
385 Interiocken Crescent
.Suite 900 .INSURER D :
Broomfield, CO 80021 INSURER E:
INSURER F
rMVFRAriF_q CFRTIFICATF MI IMRFP- RFVI-glnN NIIMRFR-
THIS IS TO CERTIFY _THAT THE POLICIES OF INSURANCES LISTED
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM
BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE 'FOR THE POLICY PERIOD
IOR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE
AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS
(SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
VTR
TYPE OF INSURANCE
INSSIR
SU D
POLICY NUMBER
MW OD EFF.
-MPO D EXP
MI
LIMITS
A
)(
COMMERCIAL GENERAL LIABILITY
Y
Y
6LOS01970712
06A540210
06/01/2021
EACHOCCURRENCE
s3,000,000
CLAIMS -MADE OCCUR
PREMISES EaEoocurtence
s3000OO
X
MED EXP (Any one person)
$1 O 000
Al: UGL 1175
PERSONAL & ADV INJURY
s3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY �.JECT LOC
GENERAL AGGREGATE
$ 6 00O 000
PRODUCTS - COMP/OP AGG
$6,000,000
$
OTHER:
A
AUTOMOBILE
LIABILITY
Y
Y
9AP563970812
-6611512010
06/01/2021
COMBINED
Ea accidentSINGLE LIMIT
3,000,000
X
BODILY INJURY (Per person)
$
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
HIRED AUTOS X NON -OWNED
AUTOS
BODILY INJURY (Per accident)
$
X
PROPERTY DAMAGE
Per accident
$
$
B
X
UMBRELLA LIAB
X
OCCUR
Y
Y
03084113
6/15/2020
06/01/2021
EACH OCCURRENCE
$5 OOO OOO
AGGREGATE
$S 000 000
EXCESS LIAR
CLAIMS -MADE
LIED X .RETENTION $1O 000
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETORMARTNERIEXECUTIVE Y I N
OFFICER/MEMBER EXCLUDED? a
(Mandatory In NH)
N/A
Y
WC6542462011
6/15/2020
06/0112021
X PER OTH-
E.L. EACH ACCIDENT
$1 O 10 000
E.L. DISEASE - EA EMPLOYEE
$1 OOO 000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE -POLICY LIMIT
1 $1,000,000
C
Professional
N
Y
PCAD950097580619
0610112019
0710112020
$1,000,000 per Claim
Liability
$1,000,000 Aggregate
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addltlonal
Remarks Schedule, may be attached N more space Is required)
Evidence of Insurance Project Description: Lincoln
Code: 8214 The following are Additional insureds as
if required by written contract and coverage applies
Insured for the Additional Insureds. The following are
to the extent they meet the definition of an insuredin
Corridor Project Location: Fort Collins, Colorado Project
respects General Liability and Umbrella Liability only
only as respects ongoing operations performed by the
Additional Insureds on the Automobile Liability only
the policy, which provides in pertinent part that an
(See Attached Descriptions)
The City of Fort Collins
Purchasing Division
215 North Mason Street
2nd Floor
Fort Collins, CO 80522-0580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2014101) 1 1 of 2 The ACORD name
#S1881731M188158
01988-2014 ACORD CORPORATION. All rights reserved.
logo are registered marks of ACORD
SGK
DESCRIPTIONS (Continued ftom Page 1)
insured includes anyone liable for the conduct of an
Additional Insureds: City of Fort Collins and its elea
agents and employees individually and collectively
conditions and exclusions of the policies apply. Thii
in effect and may or may not be in compliance with o
General Liability coverage is Primary and Non -Conti
Liability, Automobile Liability and Workers Compem
of the Additional Insureds but only if required by wr
currently in effect will be renewed on the applicable
and conditions unless cancelled.' The following cai
Non -Payment of premium - If policy shown; Ten (10)
misrepresentation; Non -Payment of Premium; other
other Notices of Cancellation Thirty (30) Days apply.
Insured but only to the extent of that liability.
ed and appointed officials, directors, officers,
nd as required by Contract. All coverages, terms,
Certificate of Insurance represents coverage currently
ny written contract andlor written agreement The
butory per the policy terms and conditions. The General
ation Policies include a Waiver of Subrogation in favor
ten contract and/or written agreement: Policies
.xpiration Dates as required with the current terns
cellation conditions always apply: Ten (10) Days for
Days for Workers' Compensation for fraud; material
reasons approved by the Commissioner of Insurance. All
RA 25.3 (2014101) 2 of 2
#S788173/M188158
Additional Insured — Auto
Contractors
iatic — Owners, Lessees Or
ZURICH
Policy No.
Eff. Date of Pol.
Exp. Date of
Pot.
Eff Date of End.
Producer No.
AWL Prem
Retum Pram.
GLO5939707-12
06/15/2020
06/01/2021
25554000
INCL
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Named Insured` FLATIRON CONSTRUCTION CORP.
Address (including ZIP Code):
This endorsement modifies insurance provided 'under the:
Commercial General Liability Coverage Part
A. Section 11— Who Is An Insured is amended to include as an additional insured any person or organization whom you
are required to add as an additional insured on this policy under a written contract or written agreement. Such person
or organization is an additional insured only with respect to liability for "bodily injury", "property damage" or "personal
and advertising injury" caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting c
in the performance of your ongoing oper
hazard", which is the subject of the written
However, the insurance afforded to such a
1. Only applies to the extent permitted by
2. Will not be broader than that which yl
such additional insured.
B. With respect to the insurance afforded to tt
This insurance does not apply to:
your behalf,
or "your work" as included in the "products -completed operations
tt or written agreement.
31 insured:
N; and
are required by the written contract or written agreement to provide for
additional insureds, the following additional exclusion applies:
"Bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or failure to
render, any professional architectural, engineering or surveying services including`
a. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports; surveys,
field orders, change orders or drawings and specifications; or
b. Supervisory, inspection, architectural or engineering activities..
This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the
supervision, hiring, employment, training or, monitoring of others by that insured, if the "occurrence" which caused the
"bodily injury' or "property damage", or the offense which caused the "personal and advertising injury", involved the
rendering of or the failure to render any professional architectural, engineering or surveying services.
U-GL-1175-F CW (04/13)
Pagel of 2
Includes mpyrighted material of Insurance Services Office, Inc., with its permission.
C. The following is added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV —
Commercial General Liability Conditions:
The additional insured must see to it that:
1. We are notified as soon as practicable of an "occurrence" or offense that may result in a claim;
2. We receive written notice of a claim or "suit' as soon as practicable; and
3. A request for defense and indemnity of the claim or "suit' will promptly be brought against any policy issued by
another insurer under which the additional insured may be an insured in any capacity. This provision does not
apply to insurance on which the additional insured is a Named Insured if the written contract or written agreement
requires that this coverage be primary and non-contributory.
D. For the purposes of the coverage provided by this endorsement:
1. The following is added to the Other Insurance Condition of Section IV — Commercial General Liability
Conditions:
Primary and Noncontributory insurance
This insurance is primary to and will not seek contribution from any other insurance available to an additional
insured provided that:
a. The additional insured is a Named Insured under such other insurance; and
b. You are required by written contract or written agreement that this insurance be primary and not seek
contribution from any other insurance available to the additional insured.
2. The following paragraph is added to Paragraph 4.b. of the Other Insurance Condition of Section IV— Commercial
General Liability Conditions:
This insurance is excess over.
Any of the other insurance, whether primary; excess, contingent or on any other basis, available to an additional
insured, in which the additional insured on our policy is also covered as an additional insured on another policy
providing coverage for the same "occurrence", offense, claim or "suit". This provision does not apply to any
policy in which the additional insured is a Named Insured on such other policy and where our policy is required by
a written contract or written agreement to provide coverage to the additional insured on a primary and non-
contributory basis.
E. This endorsement does not apply to an additional insured which has been added to this policy by an endorsement
showing the additional insured in a Schedule of additional insureds, and which endorsement applies specifically to
that identified additional insured.
F. With respect to the insurance afforded to the additional insureds under this endorsement, the following is added to
Section III — Limits Of Insurance:
The most we will pay on behalf of the additional insured is the amount of insurance:
1. Required by the written contract or written agreement referenced in Paragraph A. of this endorsement; or
2. Available under the applicable Limits of Insurance shown in the Declarations,
whichever is less.
This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
All other terms and conditions of this policy remain unchanged.
U-GL-1175-F CW (04113)
Page 2 of 2
Includes copyrighted material of Insurance Services Office, Inc., with its permission.