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HomeMy WebLinkAboutLEFT HAND EXCAVATING LLC - INSURANCE CERTIFICATE (4)CI ient#: 33545 LEFHANPC ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE iz/(MM/.D (MM/DD/VYYY) 7 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER Holmes Murphy - Colorado 7600 East Orchard Road Suite 330 South ' CONTACT Nick Brown NAME: PHONE 720-622-9110 e Ext : ac, No : 844-248-0468 E-MAIL ADDRESS: nbrown@holmesmurphy.com Greenwood Village, CO 80111 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A : GBE Insurance Corporation 39217 INSURED Left Hand Excavating, LLC 7733 N 73rd Street INSURER B : Pinnacol Assurance Company 41190 INSURER C : Atlantic Specfatty Insurance Company 27154 Longmont, CO 80503 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD _ POLICY NUMBER MM/DD/Y1/Y MM/DD/Y A X COMMERCIAL GENERAL LIABILITY X CCI1174022 1 /01 /2018 01/01/2019 EACH OCCURRENCE $1 000 000 CLAIMS -MADE � OCCUR PREMISESa occur ence $100000 X MED EXP (Any one person) $10000 PD Ded: $1,000 Ltd. Pollution- PERSONAL & ADV INJURY $1,000,000 Work Sites GEN'L AGGREGATE LIMIT APPLIES PER: PRO - POLICY r X JECT X I LOC GENERAL AGGREGATE $1,000,000 Limit $2 000,000 PRODUCTS - COMP/OPAGG $2,000,000 $ OTHER: A AUTOMOBILE LIABILITY CBA1174020 1 /01 /2018 01/01/2019 COMBINED SINGLE LIMIT Ea accident 1 000 000 e e X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY A X UMBRELLA LIAB X OCCUR CCU1174021 1/01/2018 01/01/2019 EACH OCCURRENCE $1 000000 AGGREGATE $1 000 000 EXCESS LIAB CLAIMS -MADE DED I X RETENTION $1 O 000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYER Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? a N / A 1663960 1 /01 /2018 01/01/2019 X PER OTH- E.L. EACH ACCIDENT $500OOO E.L. DISEASE - EA EMPLOYEE $500 OOO (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below 7900067540009 01 /01 /2018 01 /01 /201 — E.L. DISEASE - POLICY LIMIT $500OOO C Leased/Rented Eq. $500,000; $1,000 Ded C Installation Fit. 7900067540009 1/01/2018 01/01/201 $250,000; $1,000 Ded DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project Description: Right of Way Contractor's License The following are Additional Insureds as respects General Liability only to the extent coverage might apply according to the policy terms, conditions and exclusions. Consult the policy to determine extent of coverage. This Certificate confers no rights on the Certificate Holder. Additional Insureds: City of Fort Collins City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P O Box 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522-0580 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S330500/M330473 MANV1