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HomeMy WebLinkAboutDIAMOND EXCAVATING INC - INSURANCE CERTIFICATE (16)DIAMEXC-01 SFORSBERG ,d►CORO DATE (MMlDD YYYY) CERTIFICATE OF LIABILITY INSURANCE 03/14/2017 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 have ADDITIONAL INSURED provisions or 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 riqhts to the certificate holder in lieu of such endorsement(s). PRODUCER Forsberg Engerman Co 3575 S Sherman St Englewood, CO 80113 INSURED Diamond Excavating Inc 5940 W 59th Ave Arvada, CO 80003 CONTACT Sarah Tripp NAME: aHO.NN . IF.& (303) 762-1717 103 FAX Nol:(303) 762-1733 D: INSURER F : Cincinnati Insurance Corn !`r%Wr-DAnl=Q rFDTImrATF Kil IMRFD• RFVISIr)K1 KII 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLT. LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR X ENP 0172168 01/07/2017 01/07/2018 500,000 $ DAMAGE TO RENTED PREMI E Ea occurrence) MED EXP (Any oneperson) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY F-X] PE&_ LOC $ OTHER: A AUTOMOBILE LIABILITY Ea acccidentSINGLE LIMIT $ 1,000,000 BODILY INJURY Perperson) $ X ANY AUTO ENP 0172168 01/07/2017 01/07/2018 BODILY INJURY Per accident $ OWNED SCHEDULED AUTOS ONLY AUTOS PeOaccidentDAMAGE $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS -MADE ENP 0172168 01/07/2017 01/07/2018 AGGREGATE $ 5,000,000 DED X I RETENTION $ 10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YN ANY PROPRIETOR/PARTNER/EXECUTIVE N pFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A 2296640 04/01/2017 04/01/2018 X STAT TE X ERH- E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000 000 $ If yes, describe under DESCRIPTION OF OPERATIONS below A Leased/Rented Equip ENP 0172168 01/07/2017 01/07/2018 Limit 300,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Right of Way Contractor License The City of Fort Collins is named as additional insured with respect to general liability perform GA233CO 05/11. CERTIFICATE HOLDER GANGtLLA I IUN City of Fort Collins PO Box 580 Ft 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 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD