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Home My WebLink About592927 HASELDEN CONSTRUCTION LLC - INSURANCE CERTIFICATE (11)P52a 2WX12 ACORa CERTIFICATE OF LIABILITY INSURANCE F -DATE 03/13/20018 ) 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(iss) 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 1-303-534-4567 CONTACT NAME: PHONE FAIL IC. Noll: Hill, Inc. - Colorado Division EMAIL denaccounttechogimacorp.com ADDRESS: 1705 17th Street -- INSURER(S) AFFORDING COVERAGE NAICS suite 100 _ INSURER A: VALLEY FORGE INS CO (CNA) 20508 Deaver, CO 80202 INSURED INSURERS: CONTINENTAL INS CO(CNA InauranCO) 35289 Haselden Construction, LW INSURER CPINNACOL ASSUR 41190 INSURER D: 6950 South Potomac Street INSURER E : INSURER F: Centennial, CO 80112 rnV9RAn9Q f'FRTIFIrATF MIIURFR• 52275515 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. VISA LTR — TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MMIDD POLICY EXP MWDD LIMBS A Z COMMEROALGENERALLUIBILITY C4028808411 07/01/17 07/01/18 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE lxl OCCUR AMAGE TO RENTED PREMISES iEa occurrence) S 1,000,000 Z MED EXP (Any one Person) = 15,000 PD Ded: $10, 000 PERSONAL dADVINJURY S 1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 GENT PRODUCTS-COMP/oPAGG $ 2.000.000 _ POLICY n PRO- LOC $ OTHER: A AUTOMOBILE LIABILITY C4028808425 07/01/17 07/01/18 COMBINED SINGLELIMIT a accid" $ 1,000,000_ BODILY INJURY (Per Parwn) i Z ANY AUTO BODILY INJURY (Par aoc derd) $ ALL OWNED SCHEDULED Y— AUTOS AUTOS H NON-OWNEDPROPERTYOAMAGE -- HIRED AUTOSAUTOS S $ B Z UMBRELLALIAS N OCCUR 6042783626 07/01/17 07/01/18 EACHOCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAR_ CLAIMS -MADE DED f Z T ION$ 10, 000 S C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE a OFFICER/MEMBER EXCLUC (Mandatory in NH) N I A 4082635 - CO ONLY 07/01/17 07/01/18 Z STATUTE ETM- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE S 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached N more space Is required) City of Fort Collins, its officers, agents and employees are included as Additional Insureds on the General, Automobile and Umbrella Liability Policies if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. The Umbrella Policy is excess of the General Liability, Automobile Liability, and Employers Liability Policies. f`COTlclr ATF unI nFR CANCELLATION RE: Work Order $ OP-483743 Lincoln Center Dewatering. 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. 300 LaPorte Ave AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 // ,/ / /, USA l v!` ACORD 25 (2014/01) sadie55 52275515 %) HISS-ZU14 AGUKU GUKYUKA 1 IUN. AIi ngn[s reserveo. The ACORD name and logo are registered marks of ACORD L