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541139 GH PHIPPS CONSTRUCTION COMPANY - INSURANCE CERTIFICATE (4)
Client#: 1082464 GERALH ACORDT. CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD/YYYY) 9/28/2017 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 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Client Manager NAME:aC"r USI Colorado, LLC Construction FAX o E><t : 800 873-8500 a✓c No): 303.831-5295 P.O. Box 7050 E-MAIL SS, den.contractors@usi.com Englewood, CO 80155 800 873-8500 INSURER(S)AFFORDING COVERAGE NAIC8 INSURER A: Arch Insurance Company 11150 INSURED Gerald H. Phipps, Inc. � INSURER B : Travas Proparry Cos- Co. of Amxks 25674 dba GH Phipps Construction Company INSURERC: 5995 Greenwood Plaza Blvd, Suite 100 INSURERD: Greenwood Village, CO 80111 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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. TYPE OF INSURANCE ADD�"TR NSRL WYD POLICY NUMBER MSUBR M/DDY EFF MM/LDDXP LIMBS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X X ZAGLB9220101 10/01/2017 10/01/2018 EEAACCHq�OECTCUR��RENCE $1000000 PREMISES Ea occurrence $100000 MED EXP (Any one person) $1 O 000 PERSONAL & ADV INJURY $1 000 00O GEN'L AGGREGATE LIMIT APPLIES PER: POLICY F—xl ECTT F7LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $ 2 00O 000 $ OTHER: ZACAT9242201 A AUTOMOBILE LIABILITY X X 0/01/2017 10/01/201 Ea accdeDSINGLE LIMIT.') 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY X BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ EACH OCCURRENCE $25000000 10/0 1 /2017; 10/0 1 /2018 B X UMBRELLA LIAB X OCCUR X X ZUP15R0315317NF AGGREGATE s25,000,000 EXCESS LIAB CLAIMS -MADE DED X RETENTION$0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE -/ N OFFICER/MEMBEREXCLUDED? N/A X ZAWC19389301 10/01/201710/01/201 PER X oTH- E.L. EACH ACCIDENT $1 000 000 E.L. DISEASE - EA EMPLOYEE $1000 000 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $1 000 000 DESCRIPTION OF OPERATIONS below _ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) As required by written contract or written agreement, the following provisions apply subject to the policy terms, conditions, limitations and exclusions: the City of Fort Collins its officers, agents and employees are included as Additional Insured for work, acts or omissions under the General Liability on a primary and non-contributory basis and Additional Insured under Automobile Liability but only with respect to liability arising out of the Named Insured's work performed on behalf of the certificate holder. City of Fort Collins Attn: Tracy Oschner 281 N. College Ave. Fort Collins, CO 80524 CANULLLA I ION 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 (2016/03) 1 of 1 #S21594476/M21586090 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BHRZP