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HomeMy WebLinkAboutLUND-ROSS CONSTRUCTORS INC - INSURANCE CERTIFICATE (5)AC"R" 0 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD YYYY) 12/27/2017 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 CONTACT NAME;_ The Harry A. Koch Co. PHONE FAx P.O. Box 45279 / • 402-861-7000 _ A/c Nod: Omaha NE 68145-0279 ADDRIESS: INSURERS AFFORDING COVERAGE NAIL # INSURED Lund -Ross Constructors, Inc. 4601 F Street P.O. Box 3688 Omaha NE 68103 s : The Cincinnati Indemnity Co c: CnVFRAAFS CFRTIFIRATF NI IMRFR• 1RR59AnAQ4 RFVIQIr)M MI IMRFR- 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 SUBR _ - POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR EPP0458713 1/12018 1/1/2019 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMI E Ea oocunence $ 500,000 MED EXP (Any one person) $10,000 PERSONAL &ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY L_ JECT 7 LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE X X I LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS EPA0458713 1/12018 1/12019 -COMBINED SINGLE LIMIT Ea accident $ 1 00 000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident $ A X UMBRELLA LIAR EXCESS LIAR X OCCUR CLAIMS -MADE EPP0458713 1/12018 1112019 EACH OCCURRENCE $ 10.000,000 AGGREGATE $10,000,000 $ DED RETENTION$ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y I N OFFICER/MEMBER EXCLUDED9 (Mandatory in NH) It yes, descnbe under DESCRIPTION OF OPERATIONS below N / A EWC0463530 1/12018 1/12019 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE -- $ 500,000 - _— $ 500,000 E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins PO Box 580 Fort Collins CO 80522-0580 I.AIVI.tLLA I IVN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTH0)EaFD REPRESENTATIVE e © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD