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DUNRITE EXCAVATION INC DBA DURITE X INC - INSURANCE CERTIFICATE
,4coRO® CERTIFICATE OF LIABILITY INSURANCE `...�-� DATE(MM/DD-5 Y) 5/29/2015 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, the policy(ies) must be endorsed. If 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 endorsement(s). PRODUCER Moody Insurance Agency, Inc. 8055 East Tufts Avenue Suite 1000 Denver CO 80237 CONTACT Gail Clark NAME: PHONE0. FAX (303)824-6600 1 A/C No: (303)370-0118 E-MAIL Gail.Clark@moodyins.com ADRESS INSURERS AFFORDING COVERAGE NAIC# INSURERA:Cincinnati Insurance CoTpany 10677 INSURED Dunrite Excavation, Inc., DBA: Dunrite X, Inc. 21506 Weld County Road 1 Berthoud CO 80513 INSURERB:Pinnacol Assurance 41190 INSURERC: INSURERD: INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BEL9, i1AVE BEEN' ISSIUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TEtaNI Okt CONDITION OF ANY CQ14TRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AF0bF �`J 1W 1OLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DDNYYY POLICY EXP MM/DDNYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxIOCCUR EPP0194087 6/13/2015 6/13/2016 DAM MAGISES E TO Ea RENTED PREMoccurrence $ 100,000 MED EXP (Any one person) $ 10,000 PERSONAL BADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS PP0194087 6/13/2015 6/13/2016 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED AUTOS NON -OWNED AUTOS $ X UMBRELLALIAS X OCCUR EPP0194087 EACH OCCURRENCE $ 1,000,000 X AGGREGATE $ 11000,000 A EXCESS LIAB CLAIMS -MADE DED I X RETENTION$ 0 2nd layer excess liability $ 11000,000 ZUP15N9572215NF 6/13/2015 6/13/2016 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / NORY, X I WC STATU- OTH- E.L. EACH ACCIDENT $ 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N /A 012848 6/1/2015 6/1/2016 E.L. DISEASE- EA EMPLOYE $ 1, 000,000 If yes. describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY OMIT 1 $ 11000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) GL Blkt Al, WOS; AL Blkt AI, WOS L;tH I IrIlLrA l t HULUtH L;ANLtLLA I IVN City of Fort Collins 300 LaPorte Ave. Fort Collins, CO 80521 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 Gail Clark/GAICLA o��1 ACORD 25 (2010/05) INS025 (201005).01 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD