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HomeMy WebLinkAboutK R SWERDFEGER CONSTRUCTION INC - INSURANCE CERTIFICATE (7)uQcws:Pn-n1 AWILLIAMSON1 ��R� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1212812016 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 License # 0757776 1UB International Insurance Services (COL) 1414 W 4th 'ueblo, CO 81004 NAME CT Mary Ann Eurich PHONE 719 546-6836 ('VC (A/C, No, Ext): ( ) (ac, No): ADDREs • maryann.eurich@hubinternational.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: The Phoenix Insurance Company 25623 INSURED K R Swerdfeger Construction Inc. 421 E Industrial Blvd Pueblo West, CO 81007 INSURER B: Travelers Property Casualty Company of America 25674 INSURER C : The Travelers Indemnity Company 25658 INSURERD: 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. NSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY YEXPLTR YYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR DTC05643B507PHX17 01/01/2017 01/01/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence 300,000 $ MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2'000,000 $ B AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS WN AUTOS ONLY AUOTOS ONLY DT8105643B507TIL17 01/01/2017 01/01/2018 NED (Ea so identSINGLE LIMB $ 1,000,000 BODILY INJURY Perperson) $ BODILY INJURY Per accident $ Por'a.. -Z DAMAGE $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE DTSMCUP5643B507TIL17 01/01/2017 01/01/2018 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED I X RETENTION $ 10,000 C WORKERS COMPENSATION YIN AND ROPRIETOR/P RTNEY ANY PROPRIMBER/PXCLUDE/EXECUTIVE ❑ N1Fandatory in NH) EXCLUDED? If yes, describe under DESCRIPTION OF OPERATIONS below N / A DTKUB5643BS0717 01/01/2017 01/01/2018 PER 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 $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 'ROJECT: WATER, WASTEWATER, & STORMWATER UTILITY PROPOSAL #P951 CITY OF FT. COLLINS 215 N. Mason St FT. COLLINS, CO 80522-0000 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) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD