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HomeMy WebLinkAbout113060 MOUNTAIN CONSTRUCTORS INC - INSURANCE CERTIFICATE (10)Client#: 33585 MOUCONPC ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1 6/27/2018 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 have ADDITIONAL INSURED provisions or 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER Holmes Murphy - Colorado 7600 East Orchard Road, Suite 330 South Greenwood Village, CO 80111 CONTACT NAME: Nick Brown PHONE 720-622-9110 FAX 844-248-0468 ACINo Ext : A/C, No ADDRESS: nbrown@holmesmurphy.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Traveler: Indemnity Company 25658 INSURED Mountain Constructors, Inc. INSURER B : Travelers Property Casualty Co. America 25674 INSURER C : Pinnsea Assurance Company 41190 622 Main Street PO Box 405 Platteville, CO 80651 INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 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. LTRA TYPE OF INSURANCE ADDNSI NSRL SUBR WVD POLICY NUMBER MM/DDY EFF POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY X DTC0326DO332IND18 7/01/2018 07/01/2019 EACHOCCURRENCE $1 OOOOOO PREMISES (ERENTED occurrence) $300 OOO CLAIMS -MADE 4 OCCUR X MED EXP (Any one person) s5,000 PD Ded: $1,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- POLICY I ^I JECT LOC PRODUCTS - COMP/OP AGG $2,000,000 $ OTHER: B AUTOMOBILE LIABILITY DT810326DO332TIL18 7/01/2018 07/0112019 COMBINED SINGLE LIMIT Ea accidentr r 1 OOO OOO BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED X NON -OWNED X AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ $ X rive Oth Car B X UMBRELLA LIAB X OCCUR CUP5J4158051826 7/01/2018 07/01/2019 EACHOCCURRENCE s8000OOO AGGREGATE $8 000 000 EXCESS LIAB CLAIMS -MADE DIED I X RETENTION $1 O 000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) N / A 3027994 7/01/2018 07/01/2019 X PER OTH- E.L. EACH ACCIDENT $1 000 000 E.L. DISEASE - EA EMPLOYEE $1 000 000 E.L. DISEASE -POLICY LIMIT $1 ,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below j j _ B Leased/Rented QT6605059R618TIL18 7/01/2018 07/01/201 $250,000; $1,000 Ded B Installation Fit. QT6605059R618TIL 7/01/2018 07/01/201 $210,000; $1,000 Ded DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: 8266 Timberline 8r Prospect Intersection Improvement As required by written contract or written agreement, the Certificate Holder is included as Additional Insured under General Liability and Automobile Liability with respect to the above referenced. City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 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 ACORD 25 (2016/03) 1 of 1 1iC4ARRQ7/MZAR44d © 1988-2015 ACORD CORPORATION. All rights reservea. The ACORD name and logo are registered marks of ACORD UANVII