No preview available
HomeMy WebLinkAbout150588 WALSH CONSTRUCTION INC - INSURANCE CERTIFICATE (32)OP ID: RG AFRO CERTIFICATE OF LIABILITY INSURANCE DATE 07/02/2018 Y) 07/02/2018 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 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 Phone:970-223-1804 ONTACT NAME: Front Range Insurance Group 2002 Caribou Drive, Ste. 101 Fax: Fort Collins, CO 80525 David A. Wooldridge LUTCFAAI PHONE FAX A/c No Ext : Arc, No): E-MAIL PRODUCER CUSTOMER ID #: WALSH-4 INSURER(S) AFFORDING COVERAGE NAIC # INSURED Walsh Construction, Inc. INSURER A: Pinnacol Assurance 41190 Matthew Walsh, Pres. 8139 Open View Place Loveland, CO 80537 INSURER B: Bitco General Insurance Corp INSURER C: Hamilton Specialty Insurance INSURER D : RSUI Indemnity Company 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 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 TYPE OF INSURANCE LTR AD L UB POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS B C B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX7 OCCUR X Pollution Liab X CLIP 3 670 670 AHSECC12316-00 CLIP 3 670 670 07/01/2018 09/22/2017 07/01/2018 07/01/2019 09/22/2018 07/01/2019 I EACH OCCURRENCE $ 1,000,00 PAMAGE TO RENTED REMISES Ea occurrence) $ 300,00 MED EXP (Any one person) $ 10,00 PERSONAL &ADV INJURY $ 1,000,00 X RailRoad Liab GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO LOC PRODUCTS - COMP/OP AGG $ 2,000,00 Poll Liab $ 1,000,00 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X CAP 3 670 671 CAP 3 670 671 CAP 3 670 671 CAP 3 670 671 07/01/2018 07/01/2018 07/01/2018 07/01/2018 07/01/2019 07/01/2019 07/01/2019 07/01/2019 COMBINED SINGLE LIMIT $ 1,000,00 X Baccident) BODILY INJURY NJ BODILURY (Per person) $ X BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X Comp Deduct $ 50 Coll Deduct $ 50 B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CUP 2 814 437 07/01/2018 07/01/2019 EACH OCCURRENCE $ 3,000,00 AGGREGATE $ 3,000,00 DEDUCTIBLE RETENTION $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A X 4104361 05/01/2018 05/01/2019 WC STATU- I X OTH- T RY LIMIT S ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,00 C Contractors Equip CLP 3 670 670 07/01/2018 07/01/2019 Inst Floa 353,00 Leas/Rent 250,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) As respects the City of Fort Collins, State of Colorado, M.A. Mortenson Company and Woodward Inc, subcontractor's operations on this project, the City of Fort Collins, State of Colorado, M. A. Mortenson Company and Woodward Inc are included as additional Insureds under the General Liability, I,tK I II-IL;A I t MULUtK CITYFC2 City of Fort Collins 300 Laporte Ave 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 © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD No Text