HomeMy WebLinkAbout304369 CONTINENTAL HARDSCAPE SYSTEMS LLC - INSURANCE CERTIFICATE (4)/
ACoR" CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
5/25/2017
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
Flood and Peterson
PO Box 578
Greeley CO 80632
CONTACT Javier Perez
NAME:
PHONE (970)356-0123 FAX No:(970)330-1867
-MAILADDRESS: JPerez@F1oodPeterson.com
E-MAIL-ADDRESS:
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A:Westfield Insurance Company
24112
INSURED
Continental Hardscape Systems, LLC
6401 E 72nd Avenue
Suite 105
Commerce City CO 80022
INSURER B :Pinnacol Assurance
16535
INSURERC:
INSURER D :
INSURER E
1 INSURER F
COVERAGES CERTIFICATE NUMBER:CL1752517843 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 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.
INSRr TYPE OF INSURANCE
LTR II
D
BRI
POLICY NUMBER
MM/DDnYYY
MMLDD/YYYY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
500,000
A
CLAIMS -MADE X i OCCUR
PREMISES Ea occurrence
$
MED EXP (Any one person)
$ 5,000
CWP1817099
7/17/2017
7/17/2018
PERSONAL 8 ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
� PRO -
POLICY C LOC
PRODUCTS - COMP/OPAGG
$ 2,000,000
$
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY (Per person)
$
ANY AUTO
A
^i
BODILY INJURY (Per accident)
$
X ALL OWNED SCHEDULED
CWP1817099
7/17/2017
7/17/2018
AUTOS AUTOS
NON -OWNED
X X
PROPERTY DAMAGE
Per accident)$
HIRED AUTOS AUTOS
Medical payments
$ 5,000
X
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 3,000,000
AGGREGATE
$ 3 000 000
A
EXCESS LIAB
CLAIMS -MADE'
DED X RETENTION$ 0
$
CWP1817099
7/17/2017
7/17/2018
WORKERS COMPENSATION
X PER OTH-
STATUTE I ER
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$ 1,000,000
B
OFFICER/MEMBER EXCLUDED? Y�
(Mandatory in NH)
N / A
4179574
1/1/2017
1/1/2018
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 11000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
A
Leased/Rented Equipment
CWP1817099
7/17/2017
7/17/2018
Limit 50,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
City of Fort Collins is listed as an Additional Insured as their interest may appear as respects General
Liability, for ongoing operations only. Insurance is primary and non-contributory.
ER
City of Fort Collins
PO Box 580
Fort Collins, CO 80522-0000
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)
INS025 ont4nn
Javier Perez/JPEREZ
U 1988-2014 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD