Loading...
HomeMy WebLinkAbout476316 BEDROCK LLC - INSURANCE CERTIFICATE (6)AC� © DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 2/23/2017 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 CONTACT K lie Care CISR NAME: y y• Flood and Peterson A/c° No Ext (970) 266-7148 A/C No: FAX (970)506-6845 PO Box 578 E-MAIL KCare @flood eterson.com annaFcc• Y P Greeley CO 80632 INSURED Bedrock, LLC 1501 Backhoe Road INSURERA:Westfield Insurance I INSURER C:Travelers Property Casualtv Co INSURER E : _ Loveland CO 80537 INSURERF: COVERAGES CERTIFICATF NUMRER-CL1722316341 REVISION Nt]MRFR- 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 I OF INSURANCE ADDLTYPE INSO SUER POLICY NUMBER MM POLICY /DDNYYY1 POLICY EXP (MM/DDNYYYI LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE X� OCCUR DAMAGE ( RENTED PREMISESS Ea occurrence $ 500,000 MED EXP (Anyone person) $ 5,000 TRA5246965 3/1/2017 3/1/2018 PERSONAL &ADV INJURY $ 1,000,000 L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY 7 P O LOC 70THER: PRODUCTS-COMP/OPAGG $ 2,000,000 Employee Benefits $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accide nt $ 1,000,000 X BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS TRA5246965 3/1/2017 3/1/2018 BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident)$ NON -OWNED HIRED AUTOS X AUTOS Medical payments $ 5,000 X I UMBRELLA LIAB X_ OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 A EXCESS LIAB CLAIMS -MADE DED X RETENTION$ 0 $ TRA5246965 3/1/2017 3/1/2018 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE (Mandatory in NH EXCLUDED? ( Y ) N/A 4069771 3/1/2017 3/1/2018 X PER OTH- STATUTE I I ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1, 000, 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1 000 0 00 C Leased/Rented Equipment 4B594650 3/1/2017 3/1/2018 $70,000 Limit DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named insured. l.tri I Ir`It.A I r 11ULLJrN iL AIVIaLLA I IUN City of Fort Collins P.O. Box 580 215 N Mason St., 2nd Floor Fort Collins, CO 80522 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) INS025 (201401) K Carey, CISR/KCAREY CJ- © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD