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HomeMy WebLinkAbout479201 HEATH CONSTRUCTION LLC - INSURANCE CERTIFICATE (4)P5260028002 ACC l2L?� V66.�CERTIFICATE OF LIABILITY INSURANCE FOAIE(MMtDDNYYY) /18/2015 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 terns 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 1-303-534-4567 IMA, Inc. - Colorado Division CONTACT NAME: PHONE FAX A/C No): 1705 17th Street E-MAIL DenACCountTechs@imaco ADDRES8: Z-p • con INSURERS AFFORDING COVERAGE NAIC 0 Suite 100 INSURERA: CHARTER OAR FIRE INS CO(Travelers) 25615 Denver, CO 80202 INSURED INSURERS: TRAVELERS IND CO 25658 Heath Construction, LLC INSURERC: STARR IND & LIAB CO(RT Specialty) 38318 INSURERD: ZURICH AMER INS CO(Pinnacol Assurance) 16535 141 Racquette Drive INSURERE: PINNACOL ASSUR 41190 P.O. Box Drawer H INSURER F: Fort Collins, CO 80522 COVERAGES CERTIFICATE NUMBER, 45017819 RFVIRInN NIIMRFR- 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. INTSRR TYPE OF INSURANCE ADDL INK UBR imaMMIDDPOLICY/YYYY POLICY NUMBER EFF POLICY MIW LIMITS A X COMMERCIAL GENERAL LIABILITY DTC07F694337COF15 04/30/15 04/30/16 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR AMAGE ENTED PREMISES Ea occurrence $ 300, 000 X MED EXP (Any one person) $ 5,000 $5, 000 PD Deductible PERSONAL BADVINJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 GEN'L POLICY � PRO- POLICYJECT ❑ LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY DT8107F694337IND15 04/30/15 04/30/16 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED AU AUTOS A BODILY INJURY (Per accident ) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ $ C X UMBRELLALIAB X OCCUR 1000021757 04/30/15 04/30/16 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10, 000, 000 EXCESS UAB CLAIMS -MADE DED RETENTION $__ $ D E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N NIA WC969178403-Other States 3096125—Colorado 10/01/15 10/01/15 10/01/16 10/01/16 X STATUTE ERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below I I E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) City of Fort Collins and State of Colorado are included as Additional Insureds on the General and Automobile Liability Policies if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. GtK I INUA I It MOLUEK CANCELLATION RE: 7675 South Transit Center - Bike Shelter Addition. City of Fort Collins 300 Laporte Ave. Fort Collins, Co 80522 USA 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 M& ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD alexmtz 45017819 00 r N_