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HomeMy WebLinkAbout380591 J2 CONTRACTING COMPANY INC - INSURANCE CERTIFICATE (8)DATE (MM/DD/YYYY) A`COR " CERTIFICATE OF LIABILITY INSURANCE 12/21/2015 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 NAME CT Jennifer Winter, CISR Flood and Peterson PHONE (970)356-0123 A/CNo:(970)330-1867 PO Box 578 A RIESS:awinter@floodpeterson.com INSURER(S) AFFORDING COVERAGE NAIC # Greeley CO 80632 INSURERA:Phoenix Insurance Company 25623 INSURED INSURERB:Charter Oak Fire Insurance Company 25615 J2 Contracting Company, Inc. INSURER C 'Travelers Property Casualty CompanV 25674 Po Box 129 INSURERD:Pinnacol Assurance 41190 INSURER E : _ Greeley CO 80 632 INSURER F CAVPRA(_GC rTFRTIFIRATF NI IMRFR•CL15122107969 PI ISInN NI IMRFR• 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. TYPE OF INSURANCE I DL U POLICY NUMBER MINUDD EFF MMID Y EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 rA CLAIMS -MADE 51OCCUR PREMISESEa occu ence $ 300,000 X MED EXP (Any one person) $ 5,000 PD Ded:2,500 DTC0325D6576PHX16 1/1/2016 1/1/2017 PERSONAL 8 ADV INJURY $ 1, 000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY jEO- F LOC PRODUCTS - COMP/OP AGG $ 2,000,000 Employee Benefits Liability $ 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 $ BODILY INJURY (Per person) $ $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS 1XX DT810325D6576COF16 1/1/2016 1/1/2017 BODILYINJURY(Peraccident) PROPERTY DAMAGE $ NONOWNED HIRED AUTOSXAUTOS $ Drive Other Car X UMBRELLA LIAB IOCCUR XCLAIMS-MADE EACH OCCURRENCE $ 4 000 000 AGGREGATE $ 41000,0.00__ C EXCESS LIAB DED I X I RETENTION$ 10,000 $ DTSMCUP325D6576TIL16 1/1/2016 1/1/2017 D WORKERS COMPENSATIONOTH- AND EMPLOYERS' LIABILITY N YIN ANY OFFICER/MEIMBER/EXCLUDED? ECUTIVE N (Mandatory in NH) NIA 3114522 10/1/2015 10/1/2016 X STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1 000 ,000 IF yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1 $ 11000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is listed as an Additional Insured as respects General Liabillity. Insurance is primary and non-contributory. CERTIFICATE HOLDER CANCELLATION City of Fort Collins Purchasing Division PO Box 580 Fort Collins, CO 80522-0580 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 J Winter, CISR/JWINTE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 /9m4nn