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Home My WebLink About479201 HEATH CONSTRUCTION - INSURANCE CERTIFICATE (12)P526W1NW2 $ DATE (MMI ONYYY) ACO CERTIFICATE OF LIABILITY INSURANCE 09/15/2017 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 1-303-534-4567 CONTACT INA, Inc. - Colorado Division PHONE FAX IAC Nol 1705 17th Street ADDRE E-MAIL SS: DenAccountTechsaimatCorp.com Suite 100 INSU S AFFORDING COVERAGE NAK:S Denver, CO 80202 INSURERA:CHARTER OAE FIRz INS CO(Travelers) 25615 INSURED INSURER B: TRAVZL W IHD CO 25658 Heath Construction, LLC INSURERC: TRAVZLUB PROP CAB CO OF ANSR 25674 INSURER D: PnGMWL ASSUR 41190 141 Racquette Drive P.O. Box Drawer H INSURER E: Fort Collins, CO 80522 INSURERF: ____._.____... ...��.. �...,..��.,. OC\/ICIAaI IJI IaaRFR• GU V GKAU CJ 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 SUER POLICY NUMBER POLICY EFF MMID POLICY O MMIDD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE RX OCCUR DTC07F694337COF16 04/30/17 04/30/18 EACH OCCURRENCE $ 1,000,000 DAMAGE T PREMISES Ea occuE ence $ 300, 000 E MED EXP (Any one person) $ 5,000 $5, 000 PD Deductible PERSONAL BADVINJURY $ 1,000,000 GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OPAGG $ 2,000,000 PRO- ❑ LOC JECT $ B OTHER: AUTOMOBILELL4mLRY DT8107F794337TIL17 04/30/17 04/30/18 DSINGLELIMIT COM�BIINErill (EaE $ 1,000,000 INJURY (Per person) $ ANY AUTOBODILY ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS Ix AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ C g UMBRELLA LIAB EXCESS LIAR E OCCUR CLAIMS-MJA.E CUP4J02027A1726G 04/30/17 04/30/18 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10, 000, 000 _ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below X STATUTE ER $ D NIA 3096125 - Colorado 10/01/17 10/01/18 E.L. EACH ACCIDENT S 1,000,000 E1.DISEASE -EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) City of Fort Collins, Admin Services Purchasing Division are included as Additional Insureds on the General Liability Policy if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. L13 City of Fort Collins Admin Services Purchasing Division PO Box 580 Fort Collins, CO 80522-0580 ACORD 25 (2014/01) francine 50785571 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 USA W IUoVYV M nvvn✓ V '. v.v+..v... — ..a...- .-- The ACORD name and logo are registered marks of ACORD