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HomeMy WebLinkAbout103166 ZAK DIRT INC - INSURANCE CERTIFICATE (7)Client#: 38185 ZAKDIRPC ACORD-. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 104/28/2017 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: PHONE 515 223-6800 FAx A/C, No, Ext : AIC, No E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Zurich American Insurance Compa 16535 INSURED INSURERB: 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 PAVE 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 INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I OCCUR BI Ded:2,500 X X GL0485843201 5/01/2017 05/01/2018 EACHOCCURRENCE$1,000,000 PREMISES (E. or,. rence) $ 500 000 X MED EXP (Any one person) $10,000 PERSONAL BADVINJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY FXJJ CT 7 LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OPAGG $2,000,000 $ A AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS X AUTOS X Drive Oth Car BAP485843301 5/01/2017 05/01/201(CEO, aocideDiSINGLE LIMIT $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ B X UMBRELLA LIAB X OCCUR EXCESS LIAB CLAIMS -MADE DED I X RETENTION $0 ZUP91M6242917NF 5/01/2017 0510112018 EACH OCCURRENCE $10000000 AGGREGATE $10 000 000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) If yes, describe undF DESCRIPTIONO. OPERATIONS below N I A X WC485843101 5/01/2017 05/01/201 X PERLITE OTH- E.L. EACH ACCIDENT $1 000 000 E.L. DISEASE - EA EMPLOYEE $11000,000 E.L. DISFASF - POLICY LIMIT $1,000,000 _. — _ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: N College Improvements City of Fort Collins and Colorado Department of Transportation are included as additional insureds as respects the General Liability, as required by written contract, per the policy terms and conditions. City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Purchasing Division ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE A ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #S284011 /M284006 ATEC 1