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Home My WebLink About564493 G ORR CONSTRUCTION - INSURANCE CERTIFICATEACOR& CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD 12/28/2015015 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: Renee McReynolds PHONE (970) 679-7344 A//C No: (866) 425. 6180 Ewing -Leavitt Insurance Agency 4025 St. Cloud Dr. DRE .emcey ADE-MAIL rene-rnolds@leavitt.com INSURERS AFFORDING COVERAGE NAIC # Suite 100 INSURERA:Cincinnati Specialty UW 13037 Loveland CO 80538 INSURED INSURERB:Plnnacol Assurance 41190 INSURER C G . Orr Construction Ltd INSURER D 201 Commerce Drive INSURER E INSURER F Fort Collins CO 80524 COVERAGES CERTIFICATE NUMBER:CL156500442 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 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 ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7XI OCCUR CSU0069302 /15/2015 /15/2016 DAMAGE T RENTED PREMISES Ea occurrence $ 100,000 MED EXP Any one person) $ EXCLUDED PERSONAL & ADV INJURY $ 1,000,000 X Blkt WOS X Blkt addl insureds GENERAL AGGREGATE $ 2,000,000 Additional insured form GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 ncludes completed ops 17 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED AUTOS NON -OWNED AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYORYANYPROPRIETOR/PARTNER/EXECUTIVE YIN (Mandatory OFFICEMEBER in NH) EXCLUDED? N / A 4187053 10/21/201511/1/2016 X WC STATU- I OTH- E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYE $ 100,000 If yes, describe under E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder will be given 30 day written notice should the insurance be cancelled or non -renewed; however 10 day notice will apply in the event of non-payment of premium. Certificate holder, its officers, agents and employees are named as additional insureds as respects general liability. L,tK I It-II,A I t NULUtK C:ANUELLA I ION City of Fort Collins P O 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 ACORD 25 (2010/05) 1 NS025 (201005).01 McReynolds/RESTEI �t®e--� © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD