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Home My WebLink About184254 DURAN EXCAVATING INC - INSURANCE CERTIFICATE (14)'`�R E® CERTIFICATE OF LIABILITY INSURANCE DAT11/20/D/YYIY) 1120l2017 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 endorsements . PRODUCER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 CONTACT NAME: CLIENT CONTACT CENTER PHONE A/c No Ext : 888-333-4949 FAX A/c No): 507-446-4664 E-MAIL ADDRESS: CLIENTCONTACTCENTER FEDINS.COM OWATONNA, MN 55060 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 397-432-6 INSURER B: DURAN EXCAVATING INC INSURER C: 14332 COUNTY ROAD 64 INSURER D: GREELEY, CO 80631-9317 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 11 REVISION NUMBER: 0 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 INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DDIYYVY POLICY EXP MMIDD/YVYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F OCCUR Y N 9911663 01/01/2018 01/01/2019 EACH OCCURRENCE $1,000,000 A AGE � a occuErrence RENTD$100,000 PREMISES MED EXP (Any one person) EXCLUDED GEN'L �OTHER: PERSONAL & ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY ❑ JECT ❑ LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 A AUTOMOBILE X LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED Auros HIRED AUTOS ONLY NON -OWNED AUTOS ONLY Y N 9911663 01/01/2018 01/01/2019 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE Per a.,den A X UMBRELLA LIAB I EXCESS LIAB X OCCUR CLAIMS -MADE N N 9911666 01/01/2018 01/01/2019 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DED I I RETENTION A WORKERS COMPENSATION Y AND EMPLOYERS' LIABILITY ANY PROPRIETOR/ PARTN ERIE XECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA N 9911667 01/01/2018 01/01/2019 X PER STATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) SEE ATTACHED PAGE CERTIFICATE HOLDER CANCELLATION 397-432-6 110 CITY OF FORT COLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO BOX 580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN FORT COLLINS, CO 80522-0580 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 397-432-6 LOC #: ACOR" ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED FEDERATED MUTUAL INSURANCE COMPANY DURAN EXCAVATING INC 14332 COUNTY ROAD 64 GREELEY, CO 80631-9317 POLICY NUMBER SEE CERTIFICATE # 11.0 CARRIER NAIC CODE SEE CERTIFICATE # 11.0 EFFECTIVE DATE: SEE CERTIFICATE # 11.0 AUUI I IUNAL KtMAKKJ THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOUR ENDORSEMENT FOR GENERAL LIABILITY. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT ENDORSEMENT FOR BUSINESS AUTO LIABILITY. ADDITIONAL INSURED ALSO INCLUDES THE STATE OF COLORADO AND THE CITY OF FORT COLLINS. PROJECT: 8125 INTERSECTION IMPROVEMENTS AT VINE 8 SHIELDS ACORD 101 (2008/01) O 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD