Loading...
HomeMy WebLinkAbout551661 ELDER CONSTRUCTION INC - INSURANCE CERTIFICATE (3)ACC) & CERTIFICATE OF LIABILITY INSURANCE DATE(5/20 e ) 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 Renee McReynolds Ewing -Leavitt Insurance Agency, Inc. PHONE (970) 679-7344 _AC Nu: (866)425-6180 AIL ADDRESS: renee-mcreynolds@leavitt.com 4090 Clydesdale Parkway INSURERS AFFORDING COVERAGE NAIC # Suite 101 INSURERA:Phoenix Insurance Company 25623 Loveland CO 80538 INSURED INSURER B :Charter Oak Fire Insurance Co 25615 INSURERC:Travelers Prop Casualty Ins Co 36161 Elder Construction, Inc. INSURERD:Pinnacol Assurance 41190 7380 Greendale Road INSURER E : INSURERF: Windsor CO 80550 COVERAGES CERTIFICATE NUMBER:18-19 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. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 x MED EXP (Any one person) $ 10,000 Blanket WOS X DT-CO-9K191803-PHX-18 6/8/2018 6/8/2019 x Blanket Addl Insureds PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 Additional Insured form POLICY � PRO ❑ LOC JECT includes ongoing and PRODUCTS-COMP/OPAGG $ 2,000,000 $ OTHER: completed operations AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1, 000 , 000 X BODILY INJURY (Per person) _ $ B ANY AUTO ALL OS SCHEDULED AUTOS AUTOS X DT-810-9K191803-COF-18 6/8/2018 6/8/2019 BODILY INJURY Per accident ( ) $ X PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS X AUTOS X $ Blanket Addl Insd X Blanket WOS X UMBRELLA LAB X OCCUR follow form EACH OCCURRENCE $ 5 000 000 AGGREGATE $ 5,000,000 C EXCESS LIAB CLAIMS -MADE DED I X I RETENTION 10,000 $ CUP-9K200109-18-26 6/8/2018 6/8/2019 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A incl Blanket Waiver of Subrogation 3229590 6/1/2018 6/1/2019 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEO $ 1,000,000 if yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 11000,000 C Contractors' Equipment QT-660-8F331235-TIL-18 6/8/2018 6/8/2019 $100,000 Leased/Rented Equipment - $1,000 deductible DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Fort Collins is named additional insured as respects both General and Auto Liability policies. City of Fort Collins Purchasing Department P O Box 580 Fort Collins, CO 80522 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. AUTHORIZED REPRESENTATIVE McReynolds/RESTEI� ACORD 25 (2014101) I AIRf19R ron�nn� ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD