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HomeMy WebLinkAbout184254 DURAN EXCAVATING INC - INSURANCE CERTIFICATE (16)'4CCOR & CERTIFICATE OF LIABILITY INSURANCE FDAT11/20/D/YYYY) 11 /20l2017 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 All , No Ext : 888-333-4949 Aic No): 507 446 4664 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: 44 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 DDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $100�000 MED EXP (Any one person) EXCLUDED A Y N 9911663 01/01/2018 01/01/2019 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000 000 X POLICY ❑PRO- ❑ LOC JECT PRODUCTS - COMPIOP AGG $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) X ANY AUTO A OWNED AUTOS ONLY SCHEDULED AUTOS N N 9911663 01f01/2018 01/01/2019 BODILY INJURY (Per accident) HIRED AUTOS ONLY NON -OWNED AUTOS ONLY PROPERTY DAMAGE Per accident X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $5,000,000 A EXCESS LIAB CLAIMS -MADE N N 9911666 01/01/2018 01/01/2019 AGGREGATE $5,000,000 DED RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N X PER STATUTE OTH- ER E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE A OFFICER/MEMBER EXCLUDED? NIA N 9911667 01/01/2018 01/01/2019 E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below El 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) RE: STRUCTURAL CONCRETE ENDORSEMENT CONTRACTORS LICENSE CERTIFICATE HOLDER IS ADDITIONAL INSURED FOR GENERAL LIABILITY. CERTIFICATE HOLDER CANCELLATION 397-432-6 CITY OF FORT COLLINS PO BOX 580 FORT COLLINS, CO 80522-0580 440 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 O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD