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HomeMy WebLinkAboutK.E.C.I. COLORADO INC - INSURANCE CERTIFICATE (3)ACORD, CERTIFICATE OF LIABILITY INSURANCE 10/1 /2016 DATE(MM/DD/YYYY) 1 12/31 /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 Lockton Companies NAME: EFAX rvC, No, Ext : A/C No): 8110 E Union Avenue Suite 700 Denver CO 80237 E-MAIL ADDRESS: INSURER AFFORDING COVERAGE NAIC # (303) 414-6000 INSURER A: 'rhe Charter Oak Fire Insurance Company 25615 INSURED K.E.C.I. Colorado, Inc. INSURER B : The Travelers Indemnity Company 25658 1050899 5750 W. Airport Rd. Sedalia, CO 80135 INSURERC: Pinnacol Assurance INSURER D : Travelers Property Casualty Co of America 25674 INSURER E: INSURER F : COVERAGES KECCO03 CERTIFICATE NUMBER: 12439811 REVISION NUMBER: XXXXXXX 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 INSD SUBR WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Limited Jobsite Y N I DTC06C647481 1/l/2016 1/1/2017 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence 3OO OOO X MED EXP (Any oneperson) 5,000 Pollution PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JE� LOC OTHER GENERAL AGGREGATE $ 2,000 000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO AUTOS NED SCHEDULED AUTOS NON OWNED HIRED AUTOS X AUTOS Y N DT810325D9148 1/l/2016 1/1/2017 BIND EOaccidentSINGLE LIMIT $ 1 000 000 X BODILY INJURY (Per person) $ Mx' xxX BODILY INJURY (Per accident $ XXXXXXX X PROPERTY DAMAGE Per accident $ XXXXXXX $XXXXXXX D X UMBRELLALIAB EXCESS LIAR X OCCUR CLAIMS -MADE N N DTSM325D9148 1/1/2016 1/l/2017 EACH OCCURRENCE $ 5,000,000 AGGREGATE s 5 000 000 DED I X I RETENTION $ 10,000 $ XXXXXXX WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE a OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If Dyes, describe under ESCRIPTION OF OPERATIONS below N / A N 4048534 10/1/2015 10/1/2016 PER OR X STATUTE E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE 500,000 E L. DISEASE - POLICY LIMIT $ 500000 _ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: 7519 Lemay Ave Bridge Expansion Joint. The City, its officers, agents and employees are additional insured as respects General and Auto Liability if required by written contract per policy terms and conditions. Ten(l0) Day Notice of Cancellation will be provided to the City for non-payment. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 12439811 AUTHORIZED REPRESENTATIVE City of Fort Collins Purchasing Department PO Box 280 Ft Collins CO 80522 J J ArnRn 25 12nl4/011 ©19 8 2014 ACORD CORPO ATION. All rights reserved The ACORD name and logo are registered marks of ACORD