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HomeMy WebLinkAbout150588 WALSH CONSTRUCTION INC - INSURANCE CERTIFICATE (28)OP ID: SLS ACORO CERTIFICATE OF LIABILITY INSURANCE DATE /24/12 Y01 05248 `•--�8 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). CONTACT PRODUCER Phone: 970-223-1804 NAME: Front Range Insurance Group PHONE FAX 2002 Caribou Drive, Ste. 101 Fax: ac No Ext : A/C No): Fort Collins, CO 80525 RECEIVED E E-MAIL David A. Wooldridge LUTCFAAI PRODUCER rim- n1MFR In f . WALSH-4 INSURED Walsh Construction, Inc. Matthew Walsh, Pres. 8139 Ondn View PlaCe City Manager's Office Lovel INSURERS) AFFORDING COVERAGE I NAIC # A: Pinnacol Assurance 41190 o , Bitco General Insurance Corp INSURER C ; Hamilton Specialty Insurance RSUI Indemnity Company rr)VFRA(;FC rFRTIFICATF NIIMRFR• RFVICION NIIMRFR- 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 POLICY NUMBER EFF MMIDD/YYYY MPOLICY MIDDIYYYY LICY EXP LIMITS B C B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X Pollution Liab X CP 3 656 095 HSECC12316-00 CP 3 656 095 07/01/2017 09/22/2017 07/01/2017 07/01/2018 09/22/2018 07/01/2018 EACH OCCURRENCE $ 1,000,00 DAMAGE TO RENTED PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL 8 ADV INJURY $ 1,000,00 X RailRoad Liab GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO LOC PRODUCTS - COMP/OP AGG $ 2,000,00 Poll Liab $ 1,000,00 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X CAP 3 656 096 CAP 3 656 096 CAP 3 656 096 CAP 3 656 096 07/01 /2017 07/01 /2017 07/01 /2017 07/01/2017 07/01/2018 07/01/2018 07/01 /2018 07/01/2018 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X Comp Deduct $ 50 Coll Deduct $ 50 B X UMBRELLA LIA13 EXCESS UAB X OCCUR CLAIMS -MADE CUP 2 813 296 07/01 /2017 07/01 /2018 EACH OCCURRENCE $ 3,000,00 AGGREGATE $ 3,000,00 DEDUCTIBLE RETENTION $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A X 4104361 05/01/2018 05/01/2019 TWC STATU- OTH- TORY LIMITS X ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,00( C Contractors Equip CLP 3 656 095 07/01/2017 07/01/2018 Inst Floa 353,00 Leas/Rent 250,00 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) As respects the City of Fort Collins, State of Colorado, M.A. Mortenson Company and Woodward Inc, subcontractor's operations on this project, the City of Fort Collins State of Colorado, M. A. Mortenson Company and Woodward Inc are incfuded as additional Insureds under the General Liability, L:tK I It ILA I t NULUtK L,AIVL.CLI-A I IUN CITYFC2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. 300 Laporte Ave Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD