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HomeMy WebLinkAbout201461 CONSTRUCTION CONCEPTS INC - INSURANCE CERTIFICATE (13)AC�O%ZO® CERTIFICATE OF LIABILITY INSURANCE °6�21/zo s ) 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 endorsements . PRODUCER CONTACT NAME: KarOle Peters Ewing -Leavitt Insurance Agency, Inc. PHONE (970)679-7355 FAX A/C N : (866) 237-2178 4090 Clydesdale Parkway ADDRESS, karole-peters@leavitt.com Suite 101 INSURERS AFFORDING COVERAGE NAIC # Loveland CO 80538 INSURERA:Cincinnati Insurance Co 10677 INSURED INSURER B :Pinnacol Assurance 41190 Construction Concepts Inc INSURER CAtlantic Specialty Insurance 27154 14125 Mead Street LLongmont CO 80504 1 INSURERF: 1 COVFRAGFS CFRTIFICATF NIIMRFR•18-19 WC Pr-vlgl 1N NI nURFR- 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 SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X� OCCUR Blkt Additional Insured EPP0162368 10/1/2017 10/1/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 500,000 X MED EXP (Any one person $ 10,000 X Blkt Waiver of Subro PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY a PRO- LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 Is A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS X AUTOS Blkt At X Blkt WOS EPRO162368 10/1/2017 10/1/2018 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE accident)$ X -(Per $ A X UMBRELLA LIAB EXCESS LAB _ X OCCUR CLAIMS -MADE EPP0162368 10/1/2017 10/1/2018 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DIED I X I RETENTION 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECU I IVE OFFICERWEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4031745 7/1/2018 7/1/2019 X PTATUER TE ERH IS E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 I E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 C A Builders Risk - Reporting Leased/Rented Equipment 790-01-03-05-0006 EPP0162368 10/1/2017 10/1/2017 10/1/2018 10/1/2018 Any One Structure ($1,000 ded) $2 , 500 , 000 Limit with $1,000 ded $150,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) L.tK I WIUA I t NULLJtK City of Fort Collins Purchasing Division 215 N. Mason Street 2nd Floor Fort Collins, CO 80524 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 role Peters/KAPETE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INCMr+nnenn