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HomeMy WebLinkAbout201461 CONSTRUCTION CONCEPTS - INSURANCE CERTIFICATEA� RV® CERTIFICATE OF LIABILITY INSURANCE DATE 9/30/20 5 ) 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 Karole Peters NAME: Ewing -Leavitt Insurance Agency AONN X (970)679-7355 AX No: (866)237-2178 4025 St. Cloud Dr. E-MAIL s karole-peters@leavitt.com -ADDRESSuite 100 INSURERS AFFORDING COVERAGE NAIC p Loveland CO 80538 INSURERA:Cincinnati Insurance Co 10677 INSURED INSURERB:Pinnacol Assurance 41190 Construction Concepts Inc INSURER C:Atlantic Specialty Insurance 27154 14125 Mead Street INSURERD: INSURER E : Longmont CO 80504 INSURER F: rnVFRAr:FC rFRTIFIrATF NIIMRFR•15-16 All RFVISI(]N 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. INSR LTR TYPE OF INSURANCE ADOC'.SUBR POLICY NUMBER EFF MM/DDY/YYYY IC/YYYY LIMITS MM/DD A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I —XI OCCUR Blkt Addl Insured EPP0162368 10/1/2015 10/1/2016 EACH OCCURRENCE $ 1,000,000 DA AGE To RENTED PREM SES (E. occurrence) $ 500,000 X MED EXP (Any one person) $ 10,000 X GEN'L Blkt Waiver of Sub PERSONAL BADVINJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY F7X jE� F —]LOC OTHER: GENERAL AGGREGATE $ 2,000,000 X PRODUCTS -COMP/OPAGG $ 2,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS X AUTOS Blkt Al X Blkt WOS EPP0162368 10/1/2015 10/1/2016 COMBINED SINGLE LIMIT Ea accident $ 1, 000, 000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ X $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE EPP0162368 10/1/2015 10/1/2016 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DED I X I RETENTION $ 0 $ B WORKERS COMPENSATION 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 4031745 Blanket Waiver of Subrogation 7/1/2015 7/1/2016 X PERTH- STATUTE I I ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 11000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 C Builders Risk -Reporting i 790-01-03-05-0004 10/1/2015 10/1/2016 Any One Structure ($1,000 ded) $1,500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Contractors License City of Fort Collins is named as Additional Insured on the General Liability policy as regards work performed by the insured. CERTIFICATE HOLDER CANCELLATION City of Fort Collins 281 N. College Ave. Fort Collins, CO 80526 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 Karole Peters/KAPETE 09<40_%_� © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)