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HomeMy WebLinkAbout113060 MOUNTAIN CONSTRUCTORS INC - INSURANCE CERTIFICATEClient#: 33585 MOUCONPC ACORD,,, CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 6/30/2015 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 CONTACT NAME: pat Reece Holmes Murphy -Colorado A//CN o E:,:720-622-8246 FAX A/c No: 855-668-0069 7600 East Orchard Rd, E-MAIL reece@holmesmur h Suite 330 South ADDRESS: p P _y.com_ Greenwood Village, CO 80111 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: Charter Oak Fire Insurance Comp 25615 INSURED Travelers Pro erty Casualt Co 25674 Mountain Constructors, Inc. 622 Main Street PO Box 405 Platteville, CO 80651 INSURER B: P Y INSURER C : Pinnacol Assurance Company 41190 INSURER E : CnVFRAGFR CFRTIFIr.ATF NI INIRFR- RF\/ICIntJ NI I11AR=D- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LIS-] ED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR 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. INSR ADDL SUBR - POLICY EFF POLICY EXP L_ TR TYPE OF INSURANCE INSR WVD _ POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYY LIMITS A GENERAL LIABILITY X DTC0325D6251 COF14 07/28/2014 07/28/2015 EACH OCCURRENCE $1, 000,000 X 11 COMMERCIAL GENERAL LIABILITY PAPAGF�TO RENTED MISS 33 Ea occurrence $3000OO CLAIMS -MADE � OCCUR MED EXP (Any one person) $5 000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY a PRO- JECTLOC $ B AUTOMOBILE LIABILITY DT8103918RO04TIL14 7/28/2014 07/28/2015 COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident $ B X UMBRELLA LIAR IV I OCCUR DTSMCUP3918RO04TIL 7/28/2014 07/28/2015 EACH OCCURRENCE $8 000 000 AGGREGATE $$ 000 000 EXCESS LIAB CLAIMS -MADE DED I X RETENTION $$10,000 $ C' WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEIY / N OFFICER/MEMBER EXCLUDED? N / A 3027994 7/01/2015 07/01/201 WC STATU- OTH- XLIMITS E.L. EACH ACCIDENT $1 OOO OOO E.L. DISEASE - EA EMPLOYEE (Mandatory in NH) u $1 00O 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT - $1 000 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Project Description: 7277 Intersection Improvements at Harmony & Lemay and Drake & Lemay The following are Additional Insureds as respects General Liability only if required by written contract and coverage applies only as respects work performed by the Insured for the Additional Insureds. All coverage terms, conditions and exclusions of the policy apply. Additional Insureds: State of Colorado The Additional Insured endorsement which is referenced above under Type of Insurance -General Liability is attached. I E HULUEH City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 300 Laporte Ave. ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522-0000 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S144678/M 144661 M AN V1 Client#: 33585 MOUCONPC ACORD, CERTIFICATE OF LIABILITY INSURANCE D6/30/ IDD/YYYY) /30/2015 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 CONTACTpat Reece Holmes Murphy -Colorado NAME: A/C No E,d: 720-622-8246 A/C No): 855-668-0069 7600 East Orchard Rd, ADDRESS: preece@holmesmurphy.com Suite 330 South Greenwood Village, CO 80111 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: Charter Oak Fire Insurance Comp 25615 INSURED Travelers Pro erty Casualt Co 25674 Mountain Constructors, Inc. 622 Main Street PO Box 405 Platteville, CO 80651 INSURER B : p y INSURER C : Pinnacol Assurance Company 41190 INSURER E : COVERAGES CFRTIFIr ATF NI IMRFR• RFtnclnnl nit I1111RCO. THIS INDICATED. CERTIFICATE EXCLUSIONS IS TO CERTIFY THAT THE POLICIES NOTWITHSTANDING ANY REQUIREMENT, MAY BE ISSUED OR MAY PERTAIN, AND CONDITIONS OF SUCH OF POLICIES. INSURANCE LISTED BELOW HAVE BEEN TERM OR CONDITION OF ANY THE INSURANCE AFFORDED BY THE LIMITS SHOWN MAY HAVE BEEN - POLICY NUMBER DTC0325D6251 COF14 ISSUED TO THE INSURED CONTRACTOR OTHER DOCUMENT POLICIES DESCRIBED REDUCED BY PAID CLAIMS. NAMED ABOVE FOR THE POLICY PERIOD WITH RESPECT TO WHICH THIS HEREIN IS SUBJECT TO ALL THE TERMS, INSR LTR -TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F OCCUR ADDL INSR SUBR WVD POLICY EFF (MM/DD/YYYY)_ 7/28/2014 POLICY EXP (NlM/DDNy 07/28/2015 LIMITS EACH OCCURRENCE $1 OOO 000 A X _ _ p PRMEMISESOEaocau ence $300000 MED EXP (Any one person) $5 000 PERSONAL BADVINJURY $1,000,000 GENERAL AGGREGATE $2,000 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY I X PRO F-I LOG - J_ECT AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS PRODUCTS - COMP/OP AGG $2,000,000 $ B DT8103918RO04TIL14 7/28/2014 07/28/201 EO aoBol deD SINGLE LIMIT 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per acc dent $ B X UMBRELLA LIAB EXCESS LIAB X I OCCUR CLAIMS -MADE DTSMCUP3918RO04TIL 7/28/2014 07/28/2015 EACH OCCURRENCE s8,000,000 AGGREGATE s8,000,000 DED I X R TENTION$$10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) It es, describe under DESCRIPTION OF OPERATIONS below N/A 3027994 7/01 /2015 07/01 /201 X WC STATu- OTH- E.L. EACH ACCIDENT $1 000.000 E.L. DISEASE - EA EMPLOYEE $1 00O 000 E.L. DISEASE - POLICY LIMIT $1 OOO 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Project: 7654 West Side Access Road - North College Road Improvements The City of Fort Collins and the State of Colorado (CDOT) are included as Additional Insureds as respects to General Liability. City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 300 Laporte Ave. ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE 6 v7 -&4a :� ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S144696/M144661 MANV1 Client#: 33585 MOUCONPC ACORD, CERTIFICATE OF LIABILITY INSURANCE DATE/YYYY) 6/30/201/2015 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 CONTACT NAME: pat Reece Holmes Murphy -Colorado a/c°NNo E>a:720-622-8246 No; 855-668-0069 7600 East Orchard Rd, E-MAIL RESS: preece@holmesmurphy.com Suite 330 South Greenwood Village, CO 80111 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: Charter Oak Fire Insurance Comp 25615 INSURED Travelers Pro ert Cas alt C 25674 Mountain Constructors, Inc. 622 Main Street PO Box 405 Platteville, CO 80651 INSURER B: III U y O. INSURERC: Pinnacol Assurance Company 41190 INSURER E ; COVERAGES rFRTIFIRGTF NI IRARFR• (ZCVICIrla: M1 flulDCD• 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 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. INSR LTR A _ TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 51OCCUR ADDL INSR SUER Vivo POLICY NUMBER POLICY EFF MM/DD/YYYY 7/28/2014 POLICY EXP MM/DD/YYYY 07/28/2015 LIMITS EACH OCCURRENCE PREMISES EBET ence $1 OOOOOO _ $300000 X DTC0325D6251COF14 MED EXP (Any one person) $5 000 PERSONAL & ADV INJURY $1 000,000 GENERAL AGGREGATE $2 000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X JECTPRO LOC PRODUCTS - COMP/OP AGG $2 000,000 $, B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED DT8103918RO04TIL14 DTSMCUP3918RO04TIL 3027994 7/28/2014 07/28/2015 COMBINED SINGLE LIMIT Ea accident 1,000,000 X 1AUTOS BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ B X UMBRELLA LIAB EXCESS LIAR X OCCUR CLAIMS -MADE 7/28/2014 07/28/201 EACH OCCURRENCE s8,000,000 AGGREGATE $$ 000 000 DED I X RETENTION $ 1 O 000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEr-�WC ANY PROPRIETOR/PARTNER/EXECUTIVE -/ N OFFICER/MEMBER EXCLUDED? (Mandatory If in NH) yes, describe under DESCRIPTION OF OPERATIONS below N / A 7/01 /2015 07/01 /201 STATU- OTH- X E.L. EACH ACCIDENT $1 OOO OOO E.L. DISEASE - EA EMPLOYEE _ $1 00O 000 E.L. DISEASE - POLICY LIMIT $1,000 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Project: 7557 West Prospect Road Bridge Replacement at New Mercer Ditch. Fort Collins, the Colorado Department of Transportation, and the New Mercer Ditch Company are named as Additional Insureds as respects to General Liability and Auto Liability. t,cn I Irm A I r nvl_lJtrl GANGELLA I ION City of Fort Collins 300 Laporte Ave. Fort Collins, CO 80522 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 64,0L� -& ACORD 25 (2010/05) 1 Of i #S144695/M144661 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MANV1