Loading...
HomeMy WebLinkAbout454406 BIOHABITATS INC - INSURANCE CERTIFICATE (6)ACORO® CERTIFICATE OF LIABILITY INSURANCE �� DATE (MM DD/YYYY) 12/23/2015 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: Klein Agency,. LLC. AICONNo, Ertl, (410) 832-7600 A/C No: (410)832-1849 E-MAIL ADDRESS: P.O.. .BOX 219. INSURER(SI AFFORDING COVERAGE N INSURER A:National Surety CO 4�MC Timonium MD 21094 INSURED INSURER BAmeri can Automobile Ins. Co. INSURERC:Travelers Casualty & Surety CO Bichabitats, Inc. - INSURERD:Continental Casualty Company 2081 Clipper Park Road INSURER E : INSURER F: Baltimore ND 21211-1406 COVERAGES CERTIFICATE NUMBER:16-17 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLIC'i PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VVITH 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 rypE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE ❑X OCCUR DAMAA PREM TO PREM S S( RENTED Ea occurrence $ 1,000,000 X MED EXP(Any one person) $ 10,000 Contractural Liability ABCS0908518 1/1/2016 .1/1/2017 PERSONAL B ADV INJURY $ 2,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY � PE�. LOC PRODUCTS - COMPIOP AGG $ 4,000,000 Employee Benefits $ 1,000,000 OTHER I I I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 %{ BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS t9CA80316461 1/1/2016 1/1/2017 BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ $ X UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 4,000,000 AGGREGATE Is 4,000,000 A EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ 1 $ ABC80908518 1/1/2016 1/1/2017 C WORKERS. COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) NIA UB4213TB94 All States Coverage Endorsement l/1/2016 1/1/2017 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, descriLw under DESCRIPTION OF OPERATIONS below VA is a covered State -"'"-- ---�- E.L. DISEASE - POLICY LIMIT $ 1, 00,000 D Professional Liability ECE28838926 1/1/2016 1/1/2017 Each Claim $5,000,000 Aggregate $ 5 , 000 , 0 00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H more space is required) Re: Project - 7616 Wetland, River & Floodplain Ecological Restoration See attached for specific additional insured wording. IiGR 11f'IliF11 C fIVLUGR liH1YVCLLN I Ium City of Fort Collins 215 N. Mason Street 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. AUTHORIZED REPRESENTATIVE Justin Klein/LISA -0, - k& — © 1988-2014 ACORD CORPORATION_ All rinh}s resarvo ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401) COMMENTS/REMARKS If required under an insured written contract, executed prior to any loss, City of Fort Collins are Additional Insured under the General Liability Policy, but only with respects to liability arising -from work performed by or on behalf of Biohabitats, Inc. If required under an insured written contract, executed prior to any loss, City of Fort Collins are Additional Insured under the Automobile Policy, but only with respects to liability arising from the operation of vehicles by employees of Biohabitats, Inc. If required under an insured written contract, executed prior to any loss, Waiver of Subrogation is provided for City of Fort Collins under the General Liability, Automobile Liability and Workers Compensation Policies. It is further understood that coverage provided the Additional Insured under the General Liability and Automobile Liability shall be primary and non-contributory to any other coverage available to the Additional Insured. OFREMARK COPYRIGHT 2000, AMS SERVICES INC. I ACORE> CERTIFICATE OF LIABILITY INSURANCE I`� DATE (MM DD YYI !) 12/23/2015 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: Klein Agency, LLC. (PA HONE Ext: (410) 832-7600 AA/XC No: (410)832-1849 E-MAIL ADDRESS: P.O. BOX 219 INSURERS AFFORDING COVERAGE NAIC 4 INSURER A:National Surety Co Timonium MD 21094 INSURED INSURERB'pmerican Automobile Ins. Co. INSURERC:Travelers Casualty 6 Surety CO Biohabitats, Inc. INSURERD:Continental Casualty Com an 2081 Clipper Park Road INSURER E : INSURER F: Baltimore MD 21211-1406 COVERAGES CERTIFICATE NUMBER:16-17 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN !SSUED TO THE INSURED NAMED .ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTHSTAN DING 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 I TYPE OF INSURANCE ADDLISUBR POLICY NUMBER POLICY EFF MM/DD/YYYY PODCY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A CLAIMS -MADE �X OCCUR DAMAGEISESS( RENTEDEa occurrence PREM $ 1,000,000 X MED EXP(Any one person) $ 10,000 Contractural Liability ABC80908518 1/1/2016 1/1/2017 PERSONAL B ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 1 PRO- POLICY� LOC PRODUCTS - COMP/OP AGG $ 4,000,000 Employee Benefits $ 1,000,000 OTHER: BILE LIABILITY COMBINEDSINGLE LIMIT Ea accident $ 1,000,000 INJURY(Per person) $ BLLOWNED NYAUTOBODILY SCHEDULEDAUTOS �DCA80316461 1/1/201fi 1/1/2017 FANoUTOS BODILY INJURY (Peraaident) $ PROPERTY DAMAGE Per accident $IRED NON -OWNED AUTOS AUTOS X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 A EXCESS LJAB CLAIMS -MADE DED RETENTION$ Is ABC80908518 1/1/2016 1/1/2017 Q(Mandatoryryin WORKERS COMPENSATION EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE NH MBER EXCLUDED? ) N/A UB4213T894 All States Coverage Endorsement 1/1/2016 1/1/2017 X PER STATUTE STATUTE ER E.L. EACH ACCIDENT $ 1 000 000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 Byes, Ounder N OF OPERATIONS below DESCRIPTION VA is a covered State E.L. DISEASE -POLICY LIMIT $ 1,000,000 D Professional Liability ECH28838926 1/1/2016 1/l/2017 Each Claim $5,000,000 Aggregate $ 5 , 000 , 000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached U more space is required) Re: Project - McMurry Natural Area Restoration Phase 2, and Sterling Pond Restoration See attached for specific additional insured wording flan I Irl iA l a nvLucn liHnliCLL/i I I V m City of Fort Collins Attention: John Stephen, CPPO, LEED, AP 215 N. Mason Street Fort Collin, 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. AUTHORIZED REPRESENTATIVE Justin Klein/LISA -0, © 1988-2014 ACORD CORPORATION_ All rinhtc rpsnrved_ ACORD 25 (2014101) The ACORD name and logo are registered.marks of ACORD INS025 (201401) AC40R" CERTIFICATE OF LIABILITY INSURANCE ' �/ DATE (MM/DDIYYYY) 12/23/2015 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: Klein Agency, LLC. P.O. Box 219 Ho t: (410)832-7600 AID No: (410)832-1849 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A:National Surety CO Timonium MD 21094 INSURED INSURER B Ameri Can Automobile Ins. Co. INSURER C:Travelers . CasualtV S SuretV Co Biohabitats, Inc. INSURERD:COntinental Casualty Com an 2081 Clipper Park Road INSURER E : INSURER F: Baltimore MD 21211-1406 COVERAGES CERTIFICATE NUMBER:16-17 REVISION Nt1MRFR- 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. ILTR TYPE OF INSURANCE N SD DL SUBR 11 POLICY NUMBER EFF MMI IDY/YVYY ICYEXP MM IYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A CLAIMS -MADE � OCCUR DAMA E TO RENTED PREMISES Ea occurrence $ 1,000,000 X MED EXP (Any one person) $ 10,000 Contractural Liability ABC80908518 1/1/2016 1/1/2017 PERSONAL B ADV INJURY $ 2,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 EEN'L POLICY PEC LOC PRODUCTS-COMP/OP AGG $ 4,000,000 Employee Benefits $ 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ B ANY AUTO AOLED AUTOS AUTOS AUTOS p8D316461 1/1/2016 1/1/2017 BODILY INJURY (Per accident) $ PROPERTYDAMAGE$ NON -OWNED HIRED AUTOS AUTOS $ X UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 A EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ ABC80908518 1/1/2016 1/1/2017 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA UB4213T894 All States Coverage Endorsement 1/1/2016 1/1/2017 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, descril,e under DESCRIPTION OF OPERATIONS below VA is a covered State E.L. DISEASE -POLICY LIMIT $ 1 000 000 D Professional Liability ECH28838926 1/1/2016 1/1/2017 Each Claim $5,000,000 Aggregate $ 5 , 000 , 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Re: Project - I-25 Wetlands; Biohabitats Project # 12904-01 See attached for specific additional insured wording. P1y���lr Pf1\�N City of Fort Collins, Colorado Attention: John Stephen P.O. Box 508 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. AUTHORIZED REPRESENTATIVE Justin Klein/LISA ACORD 25 (2014101) INS025 (201401) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMENTS/REMARKS If required under an insured written contract, executed prior to any loss, City of Fort Collins, Colorado are an Additional Insured under the General Liability Policy, but only with respects to liability arising from work performed by or on behalf of Biohabitats, Inc. If required under an insured written contract, executed prior to any loss, City of Fort Collins, Colorado are an Additional Insured under the Automobile Policy, but only with respects to liability arising from the operation of vehicles by employees of Biohabitats, Inc. If required under an insured written contract, executed prior to any loss, Waiver of Subrogation is provided for City of Fort Collins, Colorado under the General Liability, Automobile Liability and Workers Compensation Policies. It is further understood that coverage provided the Additional Insured under the General Liability and Automobile Liability shall be primary and non-contributory to any other coverage available to the Additional Insured. I OFREMARK COPYRIGHT 2000, AMS SERVICES INC. I