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HomeMy WebLinkAbout287763 TRAUTMAN & SHREVE INC - INSURANCE CERTIFICATE (5)a AC6RO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/22/2015 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 MARSH USA, INC. 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 Attn: Emcor.Certrequest@marsh.com / Fax: 203-229-6787 CONTACT _ _NAME_._ PHONE FAX A/C fro E-MAIL ADDRESS:— INSURER(S)_AFFORDING COVERAGE NAIC # INSURER A: Continental Casualty Company 20443 888715-EMC-TRA-15-16 _ _ INSURED TRAUTMAN & SHREVE, INC. 4406 RACE STREET INSURER B: American Casualty Company Of Reading, Pa 20427 INSURER C : Transportation Insurance Co 20494 INSURER D : DENVER, CO 80216 INSURER E : INSURER F : CERTIFICATE NUMBER: NYC-007694437-35 REVISION NUMtStK:z COVERAGES - 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. NSRADDL ILTR TYPE OF INSURANCE SUMPOLICY POLICY NUMBER EFF MM/DD/YYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY GL 4025756461 10/01/2015 10/01/2016 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 M_ED EXP (Any one person) $ 25,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 6,000,000 PRODUCTS - COMP/OP AGG $ 14,000,000 PRO- POLICY a JECT LOC $ A OTHER: AUTOMOBILE LIABILITY BUA 4025756492 10/01/2015 10/01/2016 COMBINED SINGLE LIMIT Ea BINEnt $ 2,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS X AUTOS PROPERTY DAMAGE Per accident $ Auto Physical Damage $ Included A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE L 2068208285 10/0112015 10/01/2016 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED I X I RETENTION$10,000 WORKERS COMPENSATION X STATUTE eRH $ B WC 4025756380 (AOS) 10/01/2015 10/01/2016 E.L. EACH ACCIDENT $ 1,000,000 B C AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WC 4025756394 (CA) WC 4025756377AZ, OR, WI ( ) 10101l2015 10/01/2015 10/01/2016 10/01/2016 E.L. DISEASE - EA EMPLOYE $ 1,000,000 E L DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re. all operations. Additional insureds under all policies (except Workers' Comp.) where required by contract: City of Fort Collins. CERTIFICATE HULDtK I I"I` City of Fort Collins 300 Laporte Avenue Fort Collins, CO 80524 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 of Marsh USA Inc. ACORD 25 (2014101) Heidi Bauermeister/BL l:J IJOO-cu 1% M\ WF%LJ ..U.— ....�....�...• The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 888715 LOC #: Norwalk A ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY MARSH USA, INC. NAMED INSURED TRAUTMAN & SHREVE, INC. 4406 RACE STREET DENVER, CO 80216 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Auto Physical Damage Comp / Coll Deductible $500 In the event of cancellation or material change that reduces or restricts the insurance afforded by this Coverage Part (other than the reduction of aggregate limits through payment of claims as applicable), Insurer agrees to mail prior written notice of cancellation or material change to: Certificate Holder Schedule 1. Number of days advance notice: For any statutorily permitted reason other than non-payment of premium, the number of days required for notice of cancellation as provided in paragraph 2 of either the Cancellation Common Policy Conditions or as amended by the applicable state cancellation endorsement is increased to the lesser of 60 days or the number of days required in a written contract. For non-payment of premium, The greater of (1) the number of days required by state law or (2) the number of days required by written contract. 2. Name: Notice will be mailed to: Certificate holder ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD