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HomeMy WebLinkAboutPROVIDENT CONSTRUCTION INC - INSURANCE CERTIFICATE (5)P33�,nu�nuna-•"''"� �'-y r....�� DATE (MMIDDIWYY) ACVR0 CERTIFICATE OF LIABILITY INSURANCE 06/26/2018 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 endorsement(s). PRODUCER 1-303-534-4567 CONTACT NAME: IMA, Inc. - Colorado Division PHONE 1705 17th Street A66RESS: denaccountteche@imacorp.cOm Suite 100 Denver, CO 80202 INSURERS AFFORDING COVERAGE NAIC # __ INSURERA: CONTINENTAL INS CO (CNA) 35289 INSURED Provident Construction Inc. 12424 E. Weaver Place Centennial, CO 80111 INSURERS: VALLEY FORGE INS CO(CNA Insurance) 20508 INSURERC: CONTINENTAL CAS CO (CNA) 20443 _ INSURERD: PINNACOL ASSUR 41190 INSURER E : INSURER F: ,ten\/CnA^11=0 /`COTICl/`ATC unaanco• 53176g0n RFVISIAM IUIIMRFR 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 EFF MMIDDY/YYW IC MMIDDY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY 4030406812 07/01/18 07/01/19 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE F_x1 OCCUR PREMISES a occurrence) $ 300,000 X MED EXP (Any one person) $ 5,000 PD Ded: $1, 000 PERSONAL BADVINJURY $ 1,000,000 GENI AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 POLICY jECT LOC $ OTHER. B AUTOMOBILE LIABILITY 4030406907 07/01/18 07/01/19 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) S OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY PROPERTY DAMAGE Per accident $ $ C X UMBRELLALIAB X OCCUR 5093395672 07/01/18 07/01/19 EACH_ OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED I X RETENTION$ 10,000 $ D WORKERS COMPENSATION ANO EMPLOYERS' LIABILITYYIN ANYPROPRIETOR/PARTNERIEXECUTIVE OFFI CER/MEMBER EXCLUDE1 (Mandatory in NH) NIA 4076735-COLORADO 07/01/18 07/01/19 OT- X STATUTE ERH E.L. EACH ACCIDENT —"'— $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below C Leased & Rented Equipment IM6072400334 07/01/18 07/01/19 Deductible $ 500 Limit 100,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) GERIIFIGAIE HULUEK l,A1Vl.CLLA I IUIY City of Fort Collins Attn: Ann Chantler P. 0. Box 580 Fort Collins, CO 80522 ACORD 25 (2016/03) spmaestas 53176900 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 USA ©1988-2015 ACORD GURPOKA I ION. An rlgnts reservea. The ACORD name and logo are registered marks of ACORD Ib* 00 N z W