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HomeMy WebLinkAbout521604 KECI COLORADO INC - INSURANCE CERTIFICATE (5)ACORD,,,, CERTIFICATE OF LIABILITY INSURANCE I/l/2016 DATE (MM/DD/YYYY) 9/21/2015 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 Lockton Companies 8110 E Union Avenue Suite 700 Denver CO 80237 (303) 414-6000 CONTACT NAME: PHONE FAX A/C, No, Ext : A/C, No): E-MAIL ADDRESS: INSURER AFFORDING COVERAGE NAIC # INSURER A: The Charter Oak Fire Insurance Company 25615 INSURED K.E.C.I. Colorado, Inc. 1050899 5750 W. Airport Rd. Sedalia, CO 80135 INSURER B : The Travelers Indemnity Company 25658 INSURER C : Pinnacol Assurance Travelers Property Casualty Co of America INSURER D : 25674 — INSURER E : INSURER F : VVYCf\MV 11-- —1 ,..--.— .v......�... 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 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 ILSR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR Limited Inbsite Y N DTC06C647481 1/I/2015 1/1/2016 EACH OCCURRENCE 1,000,000 PREMISES (Ea TO RENTED ) s300,000 MED EXP (Any oneperson) 5,000 X Pollution PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. POLICY PE LOC CT OTHER GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO AUTOSNED SCHEDULED HIRED AUTOS X AUTOAUTOS S Ix Y N DT810325D9148 1/1/2015 I/l/2016 BIN Di SINGLE LIMIT COMBINED $ 1,000,000 BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident $ XXXXXXX PPe, Ide DAMAGE $ XXXXXXX $ XXXXXXX D X UMBRELLA LIAB EXCESS LIAR NCLAIMS-MADE OCCUR N N DTSMCUP325D9148 I/l/2015 1/I/2016 EACH OCCURRENCE $ 8,000,000 AGGREGATE $ 8,000,000 DIED I }( I RETENTION $ 10,000 $XXXXXXX C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? FN tMandatory in NH) I( yes. 1-c1be under DESCRIPTION OF OPERATIONS below N / A N 4048534 10/1/2015 10/l/2016 - X STATUTE OET," E.L. EACH ACCIDENT $ 500.000 E.L. DISEASE - EA EMPLOYEE 500,000 E.L. DISEASE - POLICY LIMIT 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: 7519 Lemay Ave Bridge Expansion Joint. The City, its otficers, agents and employees are additional insured as respects General and Auto Liability it required by written contract per policy terms and conditions. Ten(10) Day Notice of Cancellation will he provided to the City for non-payment. CERTIFICATE HOLDER %.HnI.CLLA I IVIY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 12439811 AUTHORIZED REPRESENTATIVE City of Fort Collins Purchasingg Department PO Box 280 Ft Collins CO 80522 J At'nen'2c r')nae/nlr ©1 8 2014 ACORD CORPOICATION. All rights reserved ` ' Thn ACnGn nomc nnri Innn am rnnicfcrnri —ke of AC(1Rr)