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Home My WebLink About426767 HOFF CONSTRUCTION - INSURANCE CERTIFICATE (6)ACORa CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 4/l/2016 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 TACT Sand Schifferns, CIC E: y Flood and Peterson NE (970)266-7107 FAX No: (970)S06-684S PO Box 578 FADDRESS:SSchifferns@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC # URERASITCO General Insurance Corp 20095 Greeley CO 80632 INSURED INSURER B :Pinnacol Assurance 41190 INSURER C : GL Hoff Company dba Hoff Construction INSURERD: P.O. Box 7448 INSURERE: Loveland CO 80537 _ INSURER F : COVERAGES CERTIFICATE NUMBER CL164110021 REVISION NLJMRFR- 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 I TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DD/ LIMITS A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 X MED EXP (Any one person) $ 10,000 $2,000 PD deductible CLP3635915 4/1/2016 4/1/2017 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY � JE C LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 PER Project Aggregate $ OTHER. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ A Ix ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS CAP3635916 4/1/2016 4/1/2017 BODILYINJURY(Peraccident) $ AUTOS $ AUTOSNON-OWNED AUTOS PROPERTY DAMAGEHIRED Per accident $ Medical payments $ 5,000 X UMBRELLA LIAB R OCCUR EACH OCCURRENCE $ 5 , 000,000 AGGREGATE $ A EXCESS LIAB CLAIMS -MADE DIED I X I RETENTION$ 10,000 $ CUP2810850 4/1/2016 4/1/2017 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N❑ (Mandatory in NH) If yes, describe under N / A 2242590 4/1/2016 4/1/2017 PER TH- X STATUTE I I ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -_POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: 7536 Diagonal Walk & Stage Improvements for Poudre River Public Library District Certificate holder and owner, Poudre River Public Library District are included as Additional Insureds as required by written contract with respects to liability arising out of work performed by the named insured. u wry i ww�r� I.AIVVCLLA I IUIV City of Fort Collins 300 Laporte Ave Fort Collins, CO 80521-0000 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 (2014/01) INS025 onl4nn S Schifferns, CIC/SSC 1" U 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD