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HomeMy WebLinkAboutROBERTS EXCAVATION CORPORATION - INSURANCE CERTIFICATE (18)ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 3/28/2018 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). PRODUCER CONTACT NAME: Olson & Olson Ltd 5655 S Yosemite Street #200 PHONE tA/c. No Exc): 303-867-2055 a/c No): 303-867-2074 ADDRESS: o2@olsonandolson.com Greenwood Village CO 80111 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Westfield National Ins Co 24120 INSURED ROBER-2 INSURER B : Plnnacol Assurance 41190 Roberts Excavating 1801 1st Street INSURER C INSURERD: Berthoud CO 80513 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 491775989 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 MWDD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY TRR9707469 4/1/2018 4/1/2019 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 500.000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY IX PRO- JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER A AUTOMOBILE LIABILITY TRR9707469 4/1/2018 4/1/2019 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS A X UMBRELLA LIAB X OCCUR TRR9707469 4/1/2018 4/1/2019 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 EXCESS LIAB CLAIMS -MADE DED I X I RETENTION $ 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE 3241433 6/1/2017 6/1/2018 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,00o,000 OFFICER/MEMBER EXCLUDED? N / A -- (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder and those listed below(if any) are Additional Insureds as respects General Liability and Umbrella Liability on a Primary and Nan -Contributory basis, and Auto Liability only if required by written contract or agreement and coverage applies only as respects work performed by the Insured for the Additional Insureds. All coverage terms, conditions, and exclusions of the policy apply. The Worker's Compensation, General Liability, Auto Liability, and Umbrella Liability policies include a Waiver of Subrogation in favor of the Additional Insureds only if required by written contract or agreement. CERTIFICATE HOLDER CANCELLATION City of Fort Collins 215 N Mason St 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 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD