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103166 ZAK DIRT INC - INSURANCE CERTIFICATE (6)
Client#: 38185 ZAKDIRPC ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1 04/28/2017 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 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 Holmes Murphy -Colorado 7600 East Orchard Rd, Ste 330 South Greenwood Village, CO 80111 CONTACT NAME: aC�NN t 515 223-6800 AXAtC, No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Zurich American Insurance Compa 16535 INSURED INSURER B : Travelers Casualty Insurance Co 19046 Zak Dirt, Inc. 14290 Hilltop Road Longmont, CO 80504 INSURER C INSURER D 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. INSR LTR TYPE OF INSURANCE ADDL'SUBR INSR WVD POLICY NUMBER POLICY YYYY MFF M/LICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR BI Ded:2,500 X X GL0485843201 5/01/2017 05/01/2018 EACHOCCURRENCE$1 000,000 PREMISES Ea occurrence $500 000 X MED EXP (Any one person) $10,000 PERSONAL & ADV I NJ URY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: F7PRO- POLICY I J CT El LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X HIRED AUTOS X NON -OWNED AUTOS X rive Oth Car BAP485843301 5/01/2017 05/01/201(Ea acccideDtSINGLE LIMIT 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE ccident Per accident) $ $ B UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE ZUP91M6242917NF 5/01/2017 05101/2018 EACH OCCURRENCE $10000000 X AGGREGATE $10 000 000 DED X RETENTION$0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? [7N (Mandatory in NH) If yes, describe under I DESCRIPTION OF OPERATIONS below N / A X WC485843101 5/01/2017 05/01/201 X STAPER_ OTH- E.L. EACH ACCIDENT $1 00O 000 E.L. DISEASE - EA EMPLOYEE $1 000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is included as an additional insured as respects the General Liability and Auto Liability, as required by written contract, per the policy terms and conditions. [tla:�lii[ya\Ia:L�l��la:l City of Fort Collins P.O. Box 580 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) 1 Of 1 #S284010/M284006 ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ATEC1