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HomeMy WebLinkAbout150588 WALSH CONSTRUCTION INC - INSURANCE CERTIFICATE (29)OP ID: SLS ACORO CERTIFICATE OF LIABILITY INSURANCE D05/24ATE /2018 ) 05/24/2018 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 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: A/c No Ext : A/C No): Fort Collins, CO 80525 E-MAIL ADDRESS: David A. Wooldridge LUTCFAAI PRODUCER riIgTnMFR In a• WALSH-4 INSURERS AFFORDING COVERAGE NAIC # INSURED Walsh Construction, Inc. INSURER A:Pinnacol Assurance 41190 Matthew Walsh, Pres. INSURER B: Bitco General Insurance Corp 8139 Open View Place INSURER CHamilton Specialty Insurance Loveland, CO 80537 INSURER DRSUI Indemnity Company INSURER E : INSURER F : CnV17RAr1=C rFRTIFIrATF NI IMRFR• RFVISION 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 IN UB POLICY NUMBER MMIDDPOLICY/YYYY MM /DDfYYYY LIMITS B C B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X Pollution Liab X CP 3 656 095 AHSECC12316-00 CP 3 656 095 07/01/2017 09/22/2017 07/01/2017 07/01/2018 09/22/2018 07/01/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO HEN I ED PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 X I RailRoad Liab GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER POLICY X PROECj 7 LOC PRODUCTS - COMP/OP AGG $ 2,000,00 Poll Liab $ 1,000,00 B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 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 BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X Comp Deduct $ 50 Coll Deduct $ 50 B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CUP z s13 zs5 07/01/2017 07/01/2018 EACH OCCURRENCE $ 3,000,00 AGGREGATE $ 3,000,00 DEDUCTIBLE RETENTION $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILIT/EXECUTIVEY ANY PROPRIETOR/PARTNERY� OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 4104361 05/01/2018 05/01/2019 WC STATU- OTH- TORY LIMIT X ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYE $ 1,000,00 E.L. DISEASE -POLICY LIMIT I $ 1,000,00 C Contractors Equip CLIP 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) City of Fort Collins is named as additional insured with respects to General Liability policy. ProtJect: Fort Collins -Loveland Municipal Airport Snow Removal Equipment (SRE) Building !`00TIC11"ATO Unl nco rANrri I ATInN CITYOFF 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 215 N Mason AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD