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HomeMy WebLinkAbout150588 WALSH CONSTRUCTION INC - INSURANCE CERTIFICATE (30)OP ID: SLS `acoRo TE CERTIFICATE OF LIABILITY INSURANCE D05/2424/I2018Y) 018 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- /C No Ext A/c No): Fort Collins, CO 80525 E-MAIL ADDRESS: David A. Wooldridge LUTCFAAI PRODUCER WALSH-4 r:IICTnMFR In L'• INSURED Walsh Construction, Inc. INSURER A: Plnnacol Assurance 41190 Matthew Walsh, Pres. INSURER B: Bltco General Insurance Corp 8139 Open View Place Hamilton Specialty Insurance Loveland, CO 80537 INSURER C INSURER D : RSUI Indemnity Company INSURER E : INSURER F : C 11VFRA(_FC C1=RTI1:IRATF NI IMRFR• RFVIRIr1N 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 OF INSURANCE ADDTYPE I L POLICY NUMBER MMIDDNYYY MM/DDY EXP /YYYY LIMITS B C B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FXI 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 ,000,00 DAMAGE TO RENTED PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 X RailRoad Liab GENERAL AGGREGATE $ 2,000,00 GENT AGGREGATE LIMIT APPLIES PER. POLICY X PRO LOC JECT 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 3656096 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 2 813 296 07/01/2017 07/01/2018 EACH OCCURRENCE $ 3,000,00 AGGREGATE $ 3,000,00 DEDUCTIBLE RETENTION $ $ F $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y� OFFICER/MEMBER EXCLUDED? (Mandatoryin NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 4104361 05/01/2018 05/01/2019 WC STATU- OTH- TORY LIMITS X ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 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 I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Ft. Collins is listed as an Additional Insured with regards to the General Liability policy on ongoing and completed projects CERTIFICATE HOLDER CANCELLATION CITYOFF 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. Attn: Purchasing P.O. Box 580 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