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HomeMy WebLinkAboutAISA CIVIL INC - INSURANCE CERTIFICATE (2)Client#: 33263 AISCIVPC DATE (MM/DD/YYYY) ACORD.. CERTIFICATE OF LIABILITY INSURANCE 1 10/01/2015 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: Holmes Murphy -Colorado PHONE 515 223-6800 FAx (A/C, No, Ext): A/C No): 7600 East Orchard Rd, Ste 330 E-MAIL ADDRESS: South INSURER(S) AFFORDING COVERAGE NAIC # Greenwood Village, CO 80111 INSURER A: Zurich American Insurance Com pal 16535 INSURED Aisa Civil, Inc. P.O. Box 547 Lafayette, CO 80026 INSURERB: American Guarantee 8r Liability 26247 INSURERC: Pinnacol Assurance Company 41190 INSURER D : INSURER E : INSURER F : COVFRAGFS CERTIFICATE Nt1MRER- REVISION NUMBER - 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 TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER CP0427700511 POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY X 10/01/2015 10/01/2016 EACH OCCURRENCE $1 000 000 COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 5XI OCCUR X PREMISES ERENTED ccccnce s300,000 MED EXP (Any one person) $10 000 X PERSONAL & ADV INJURY $1,000,000 PD Ded:5,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ POLICY X PEO X LOC A AUTOMOBILE LIABILITY CP0427700511 10/01/2015 10/01/201 EeaBc,denSINGLELIMIT 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED AUTOS X I NON -OWNED AUTOS $ B X UMBRELLA LIAB X OCCUR AUC655442306 10/01/2015 10101/2016 EACH OCCURRENCE s2,000,000 AGGREGATE s2,000,000 EXCESS LIAB CLAIMS -MADE DIED I X RETENTION $O $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBEREXCLUDED? � (Mandatory in NH) NIA 4086018 10/01/2015 10/01/201 X WCSTATU- OTH- E.L. EACH ACCIDENT $500000 E.L. DISEASE - EA EMPLOYEE $500OOO _ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Right -of -Way Contractor's License 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: City of Fort Collins. UANUMLLA I IVIV City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P O Box 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522-0000 AUTHORIZED REPRESENTATIVE 6fc,7-&-e, ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S161189/M161111 LINR1