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Home My WebLink AboutADVANCED UNDERGROUND INC - INSURANCE CERTIFICATE (7)ACCO DF CERTIFICATE OF LIABILITY INSURANCE DATE [Ml 1/4/2016 DrnYY) 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 endorsements . PRODUCER TrueNorth 275 South Main Street Longmont CO 80502 CONTACT NAME: PHONE 319-366-2723 1AIG no):FAX 319-862-0612 E mAa , cart$ truenorthcom anies.com @ P INSURE S AFFORDING COVERAGE NAIC9 INSURER A:Charter Oak Fire Insurance Company 25615 INSURED ADVAUND-02 INSURERB:Travelers Insurance Company 19070 Advanced Underground Inc 10360 East 107th Place INSURERC:Pinnacol Assurance Company 41190 Brighton CO 80601 INSURER D: INSURER E: INSURER F : COVERAGES CERTIFICATF NIIMRFR• 350317184 REVISION MUMMER: 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 INSD WVD POLICYNUMBER POLICY EFF MM/DD/YYYYI POLICY EXP (MMIDDfYYYYl LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR Y DTC06GB70857COF16 1/5/2016 1/5/2017 EACH OCCURRENCE $1,000,000 DAMAGE T NTED PREMISES Ea occurrence $500,000 MED EXP (Any one person) $5,000 PERSONAL B ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY ECT LOC GENERAL AGGREGATE $2,000,000 GEN'L PRODUCTS - COMP/OP AGG $2,000,000 $ OTHER: A AUTOMOBILE LIABILITY DT8106GB70857COF16 1/5/2016 1/5/2017 COMBINED SINGLE LIMIT $1,000,000 BODILY INJURY (Per person) $ AUTO ALL OWNEDSCHEDULED nANY BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PR RTYDAMA E Per accident $ B X UMBRELLA UAB X OCCUR DTSMCUP6G8708571ND16 1/5/2016 1/5/2017 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 EXCESS LUIB CLAIMS -MADE DED X I RETENTION$ 10.000 1 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? F _N] "IA 4076345 1/1/2016 1/1/2017 PER OTH- X STATUTE ER 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 E.L. DISEASE - POLICY LIMIT 11,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Rerrlaft Schedule, may be attached U rrionl apace is required( If Yes is indicated above for add'I insd forms Gen Liab #CGD316 & CGD604 premises and completed operations, Auto Liab #CAT474 applies. If Yes is indicated above for waiver of subrogation forms Gen Liab #CGD316 Auto Liab #CAT353 and WC #WC000313 04/04 applies. Coverage is extended for work performed and required under written contract with the above named insured. City of Fort Collins PO Bx 580 Fort Collins CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTH9fUZED REPRESENTATIVE Av- 1QRR-9n1A AC(1Rn C(1RPOPATIr1N All A.h*. rocnrvnet ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD