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HomeMy WebLinkAbout129203 MARK YOUNG CONSTRUCTION - INSURANCE CERTIFICATE (2)ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) �.,...��' 12/21 /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 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 CONTACT Commercial Risk Solutions NAME: Katie Smothers _ 6600 E Hampden Ave Ste 200 n c°Nru . Extl: 303-996 7801 _ �aAc No ; 303-757-7719 Denver CO 80224 E-MAIL ksmothersftcrsdenver.com INSURED MARKY-1 Mark Young Construction, Inc. 7200 Miller Place Frederick CO 80504 COVERAGES CERTIFICATF NI IMRFR• 1399nn911A INSURER(S) AFFORDING_COV_E_RAGE NAIC # INSURER A: CNA —__ 20478 INSURER B: _ _ Walley Forge Insurance Co. 20508 INSURER c : _ American Casualty ColTny 20427 INSURER D: Pinnacol Assurance _ 41190 INSURER E: Transportation Insurance_ Co_._ 20494 INSURER F : Columbia Casualty Company 31127 r2FVICIr)N NII�ARFA• 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. POLICY EFF POLICY EXP — ILri TYPE OF INSURANCE Ab�EPlu V111aa POLICY NUMBER MM/DD/YYY MM/DD/YYY LIMITS B X _.. COMMERCIAL GENERAL LIABILITY __. CLAIMS-MADE OCCUR Y 5095053104 12/3112017 12/31/2018 EACH OCCURRENCE $ 1,000,000 AMAGE-DAMAGE PREMISES Ea occurrence $ 3W,000 MED_EXP_(Any one, person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY � JERT LOC GENERAL AGGREGATE $2,000,000 GEN'L PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY Y 5084045242 12/31/2017 12/31/2018 GOM81 ED SINGLE LIMIT$1,000,000 X ANY AUTO BODILY INJURY (Per parson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) E X _ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ $ C X UMBRELREBTENTION X OCCUR Y 5084045208 12/31/2017 12/31/2018 EACH OCCURRENCE $10,000,DD0 AGGREGATE $10,000,000 EXCESCLAIMS-MADE DED $ $ D E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N 4016391 1 1/1/2018 1/1/2019 WC5093301998 1/1/2018 1/1'2019 X STATUTE FOR E.L. EACH ACCIDENT ___�__._�.._.._— $ 1,000,000 ANYPROPRIETOR/PARTNER/EXECUTIVE Y OFFICER/MEMBEREXCLUDED? N/A E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $1,000,000 $1,000,000 (Mandatory in NH) IF yes, describe under DESCRIPTION OF OPERATIONS below A F Builders Risk SpectalForm/Theft Porution/Professional Liability 6045680802 12/31/2017 12/31/2018 C6016403435 12/31/2017 12/31/2018 I Jobsite Frame Limit 12,D00,000 5,000,000 2000000/2000000 DESCRIPTION OF OPERATIONS / LOCATIONS! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE:City of Fort Collins and 8181 General Contractor for Southeast Community Park is included as additional insured for ongoing and completed operations on the General Liability and included as additional insured on the Auto Liability with respect to operations of the named insured for the certificate holder as required by written contract. Umbrella Liabilty follows form to the General Liability and Auto Liability with respect to the additional insured. all policy tems conditions and exclsu ions apply. k,CKIIr Ik,MIr_ r1ULUtM UANLL LLAI IUN City of Fort Collins Purchasing Division 215 N. Mason St. 2nd Floor 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 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD