HomeMy WebLinkAbout344844 DUNRITE EXCAVATION INC - INSURANCE CERTIFICATE (2)7517/2018
(MMIDDNYYY)
AC R" CERTIFICATE OF LIABILITY INSURANCE
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 Deanna Zahn ACSR
NAME:
Moody Insurance Agency, Inc. PHIGNE (303) 824-6600 FAX,
No: (303)370-0116
8055 East Tufts AvenueAIL
_A_DDRESS:deanna.zahn@moodyins.com
Suite 1000 INSURE S AFFORDING COVERAGE NAIC#
Denver CO 80237 INSURERA:Cincinnati. Insurance Company 110677
INSURED
24112
Dunrite Excavation, Inc., INSURERC:Pinnacol Assurance 41190
DBA: Dunrite X, Inc. INSURERD:Travelers Prop Cas Co of America 25674
21506 Conty Road 1 INSURERE:
Berthoud CO 80513-9116 INSURERF:
r1nv1c:laer-cc rFRTIFIr ATF NI IMRF=P-18-19 No Forms 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 DIYYYY
MM DDY EXP
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
CLAIMS -MADE U OCCUR
TED
PREMISES Ea oDAMAGE TO lccu ence
$ 500,000
MED EXP (Any one person)
$ 10,000
EPP0194087
6/1/2018
6/1/2019
PERSONAL 8 ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OPAGG
$ 2,000,000
PR
POLICY FX ECT El LOC
$
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY (Per person)
$
B
X ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
X HIRED AUTOS X AUTOS
TRP5638187
6/1/2018
6/1/2019
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
$
X
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 1,000,000
RDED
AGGREGATE _ _
$ 1,000,000
A
EXCESS LIAB
CLAIMS -MADE
I I RETENTION$
$
EPP0194087
6/1/2018
6/1/2019
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
X PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
.
$ 1 000 000
E.L. DISEASE - EA EMPLOYE
$ 1,000,000
ID
OFFICER/MEMBER EXCLUDED? ElNIA
(Mandatory in NH)
4012848
6/1/2018
6/1/2019
E.L. DISEASE -POLICY LIMIT
$ 1,000,000
f yes, describe under
DESCRIPTION OF OPERATIONS below
Excess Liability
ZUP15S9137A18NF
6/1/2018
6/1/2019
Each Occurence: 3,000,000
Aggregate Limit: 3,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
CERTIFICATE HOLDER GANL tLLAI IUN _
City of Fort Collins
300 LaPorte Ave.
Fort Collins, CO 80521
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
D Zahn, ACSR/DANFLI 145_el � C
U 1985-2014 AGUKD GUKF'UKAI IVN. All rignts reservea.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
INS025 (201401)