HomeMy WebLinkAbout101027 HENSEL PHELPS CONSTRUCTION COMPANY - INSURANCE CERTIFICATE (2)/
AC"R " CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
11/16/2017
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 endorsements .
PRODUCER
Flood and Peterson
PO Box 578
Greeley CO 80632
CONTACT Rebekkah McGuire
NAME:
PHONE (970) 356-0123 (FAX
/C No: (970)330-1867
E-MAIL ADDRESS: RMcGuire@F1oodPeterson.com
INSURERS AFFORDING COVERAGE
NAIC M
INSURERA:Zurich American Insurance Company
16535
INSURED
Hensel Phelps Construction CO.
Plains District
12121 Grant Street; Suite 410
Thornton CO 80241
INSURER B :
INSURERC:
INSURER0:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:CL17102520131 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.
INSR
LTR
TYPE OF INSURANCE
ADDL
SUER
POLICY NUMBER
MOLIDY
YYY
MM D NYYYI
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 5,000,000
A
CLAIMS -MADE ❑X OCCUR
1A AGE TO RENTED
PREMISES(Eaoccurence)$
300,000
MED EXP (Any one person)
$
GL0369726413
1/1/2018
1/1/2019
PERSONAL & ADV INJURY
$ 5,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 10, 000, 000
PPOLICY JEo LOC
PRODUCTS - COMP/OPAGG
$ 10,000,000
$
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 5,000,000
BODILY INJURY (Per person)
$
A
X ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
BAP369726113
1/1/2018
1/1/2019
BODILY INJURY (Per accident)
$
PROPERTY
a cidentDAMAGE
$
X HIRED AUTOS X AUTOS NON -OWNED
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
H
AGGREGATE
$
XCESS LIAB
CLAIMS -MADE
IED RETENTION $
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y/N
ANY PROPR[ETC R/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
NIA
WC369726514
1/1/2018
1/1/2019
X PER TH-
STATUTE ER
E.L. EACH ACCIDENT
$ 11000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CITY OF FORT COLLINS IS NAMED AS ADDITIONAL INSURED.CONTRACTORS LICENSE: HENSEL PHELPS CONSTRUCTION CO.
LICENSE NO. A-30 SUPERVISORS CERTIFICATE WITH THE CITY OF FORT COLLINS FOR CERTIFICATE HOLDER: LEONARD
PLANK: CERTIFICATE NO. 293
CERTIFICATE HOLDER CANCtLLA I IUN
CITY OF FORT COLLINS
ATTN: LICENSING DIVISION
PO BOX 580
Fort Collins CO 80522-0580
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
ACORD 25 (2014/01
N Keiser, CISR/NKEISE A&,�
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