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HomeMy WebLinkAbout442066 MARTIN / MARTIN INC - INSURANCE CERTIFICATE (7)AFRO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 06/01/2018 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER Aon Risk Insurance Services west, Inc. Denver CO Office CONTACT NAME: jaCNNo. Ext): (303) 758-7688 (ac No ): (303) 758-9458 E-MAIL ADDRESS: 1900 16th Street, Suite 1000 Denver CO 80202 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURERA: The Travelers Indemnity Co. 25658 Martin/Martin. Inc. INSURERB: Travelers Property Cas Co of America 25674 12499 W. COI2 Ave co 80215-3720 USA Lakewood80 Lakew INSURERC: The Travelers Indemnity Co of America 25666 INSURERD: Starr Surplus Lines Insurance Company 13604 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570071457354 REVISION NUMBER: 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. Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM DD/YYYY LIMITS C X COMMERCIAL GENERAL LIABILITY b80-13506693EACH 06/01/2018 �6/01/2M OCCURRENCE $1,000,000 CLAIMS -MADE X❑ OCCUR DAMAGE RENTED PREMISES Ea occurrence $100,000 MED EXP (Any one person) $ 5 , 000 PERSONAL &ADV INJURY $1,000,000 GEMLAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $2,0601000 JECT POLICY M PRO ❑ LOC PRODUCTS - COMP/OP AGG $ 2 , OOO , OOO OTHER: B AUTOMOBILE LIABILITY BA-78461_848 06/01/2018 06/01/2019 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY ( Per person) X ANY AUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED ONLY AUTOS ONLY E PROPERTY DAMAGE Per accident A X UMBRELLA LIAB X OCCUR Cup-21-1008633 06/01/2018 06/01/2019 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 EXCESS LIAB CLAIMS -MADE DED I X RETENTION$10, 000 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER / EXECUTIVE [9 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A UB-5K759528 06/01/2018 06/01/2019 X STATUTE OTH ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E,L. DISEASE-PULICY LIMI f $1,000,000 D E&O-PL-Primary SLSLPR026207318 06/01/2018 06/O1/2019 Per Claim Deductible $5,000,000 $100,000 Aggregate $5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: 7638 Parking Structures Specifications and Drawings. City of Fort Collins is Additional Insured with respect to General and Auto Liability per the attached endorsements as required by written contract. 30 Days Notice of Cancellation with 10 Days Notice for Non-payment of Premium in accordance with the policy provisions. 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. City of Fort Collins AUTHORIZED REPRESENTATIVE PO BOX 580 Fort Collins CO 80522 USA eYXan ��e:t.�ifc�/�axatance c%tx�ex.� /Yt�c./nu `m V u� M N o O r` Lo O Z 0) f0 U 0) U ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD