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HomeMy WebLinkAboutDELTA CONSTRUCTION INC - INSURANCE CERTIFICATEClient#: 1082464 GERALH ACORDTN CERTIFICATE OF LIABILITY INSURANCE D 10/06/2015vv> 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 NAME: Client Manager USI Colorado, LLC - PHONE g00 873-8500 AX 303-831-5295 A/C No Ext : A/C No P.O. Box 7050 E-MAIL den.contractors@usi.biz ADDRESS: Englewood, CO 80155 INSURER(S) AFFORDING COVERAGE NAIC# 800 873-8500 INSURER A: Arch Insurance Company 111150 INSURED INSURER B : American Guarantee & Liability 26247 Delta Construction, Inc.INSURERC: Illinois Union Insurance Compan 27960 dba GH Phipps Construction ction of WY 3840 Fort Misner Lane INSURER D : Laramie, WY 82073 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 ADDLSUBR INSR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY POLICY EXP IMM/DDIYYYYL LIMITS X X ZAGLB9203300 10/01/2016 EACH OCCURRENCE $1,000,000 A X I COMMERCIAL GENERAL LIABILITY 10/01 /2015 CLAIMS -MADE �, OCCUR DAMAGE TO RENTED PREMISES Eaoccumnce _ $100,000 MED EXP (Any one person) _ $1 O 000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ JECOT _' LOC _ GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 $ OTHER: A AUTOMOBILE _ LIABILITY X X ZACAT9226000 _ 0/01/2015 10/01/201 EOaaocdeDISINGLELIMIT 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ B UMBRELLA LIAB OCCUR AEC931899004 0/01 /2015 10/01/2016 EACH OCCURRENCE $15 000 000 AGGREGATE $15,000,000 X EXCESS LIAB X CLAIMS -MADE DED I X RETENTION s25,000,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITYSTATUTE Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � N/A X ZAWC19355600 0101/201510/01/201 X PER OERT 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 0/01/2015 10/01/2016 E.L. DISEASE - POLICY LIMIT $1,000,000 ach Claim $2,000,000 C Professional Liab G23636013008 Claims Made Aggregate $2,000,000 RD: 11/04/1997 Retention $100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) As required by written contract or written agreement, the following provisions apply subject to the policy terms, conditions, limitations and exclusions: the City of Fort Collins its officers, agents and employees are included as Additional Insured for work, acts or omissions under the General Liability on a primary and non-contributory basis and Additional Insured under Automobile Liability but only with respect to liability arising out of the Named Insured's work performed on behalf of the certificate holder. 101Zug I IIII Pf1I IAll i LEA ill Ail City of Fort Collins Attn: Tracy Oschner PO Box 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. AUTHORIZED REPRESENTATIVE �C ACORD 25 (2014/01) 1 of 1 #S16408267/M16406772 ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHDZP