HomeMy WebLinkAbout541003 ECI SITE CONSTRUCTION MANAGEMENT INC - INSURANCE CERTIFICATE (5)NS 11lf, rriirfl.�
® DATE (YMIDDIYYYY)
,d►corry CERTIFICATE OF LIABILITY INSURANCE 06/28/2018
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 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 rights to the certificate holder in lieu of such endorsement(s).
PRODUCER 1-303-534-4567 CONTACT
NAME:
IMA, Inc. - Colorado Division PHONE FAX
IAIC. No. LW* _ IAIC. Not:
1705 17th Street AADDDRRE s: denaccounttechWimacorp.ccm
Suite 100 INSURER(S)AFFORDING COVERAGE NAIL/
Denver, CO 80202 INSURER A: BITDKMUS CAS CORP 20095
INSURED INSURER a: TRAVRIMM CAS INS CO OF AIf1Qt 19046
ECI Site Construction management, Inc. INSURER C TRAVSLMW PROP CAS OD OF Allot 25674
2526 14th Street SE INSURERD:
INSURER E:
Loveland, CO 80539 INSURER F:
COVERAGES CERTIFICATE NUMBER: 53245594 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.
IL.M TYPE OF INSURANCE ADDL SUER POLICY NUMBER MOLICOY EFF POLICY U�,S
LTR
A
X
COMMERCIAL GENERAL LIABILITY
CLP3669966
07/01/18
07/01/19
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE IXI OCCUR
-bA-MAGE TO -RENTED
PREMISES Ea occurrence)
$ 50,000
X
MED EXP (Any one person)
$ 5,000
PD Ded: $2, 000
PERSONAL 4 ADV INJURY
5 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GENL
AGGREGATE LIMIT APPLIES PER:
_
POLICY JEC7 ] LOC
PRODUCTS -COMPIOPAGG
$ 2,000,000
$
OTHER.
A
AUTOMOBILE LIABILITY
CAP3669305
07/01/18
07/01/19
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY (Per person)
$
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
lX
$
BODILY INJURY (Per accident)
PROPERTY DAMAGE
Per accident
X HIRED X NON -OWNED
_._. _ AUTOS ONLY AUTOS ONLY
$
$
B
UMBRELLA LIAB
X
OCCUR
ZQP61M9905A78NF
07/01/18
07/01/19
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
X
EXCESS LIAB
CLAIMS -MADE
DED X RETENTION$ 10,000
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YiN
ANYPROPRIETORIPARTNER/FXECUTIVE
OFFICER/MEMBEREXCLUDEDT
(Mandatory In NH)
NIA
WC3669965
07/01/18
07/01/19
X STATUTE ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
C
lInstallation Floater
QT6606J776196TIL18
07/01/18
07/01/19
lAny One Project
15,000,000
Temp/Transit
500,000
Deductible
1,000
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more spa" Is required)
City of Fort Collins is included as Additional Insured on the General, Automobile, and Excess Liability Policies if
required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and
conditions. A waiver of Subrogation is provided in favor of Additional Insured on the General, Automobile, Excess
Liability, and workers, Compensation Policies if required by written contract or agreement and with respect to work
performed by Insured suject to the policy terms and conditions. This Insurance is Primary and Non -Contributory on the
General Liability Policy subject to the policy terms and conditions.
l,tKI lrI6A I 11ULUCK 6AKL,GLLAI IVK
RE: Poudre River Whitewater Park.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Matt Day
PO BOX 580 AUTHORIZED REPRESENTATIVE MA
Fort Collins, CO 80522
QSA
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
njones2014
53245594
a