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357129 NARANJO CIVIL CONSTRUCTORS INC - INSURANCE CERTIFICATE (7)
/ ACC?R" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 5/24/2017 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 NAME: Jennifer Winter, CISR PHONE Xt (970)506-3206 AICNo:(970)506-6846 ADDRESS:JWinter@floodpeterson.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:Phoenix Insurance Company 25623 INSURED H & L Concrete, Inc. dba Naranjo Civil Constructors, Inc. 1863 2nd Avenue Greeley CO 80631 INSURERB:Travelers Property Casualty Company 25674 C:Pinnacol Assurance 41190 -INSURER INSURERD: INSURERE: INSURER F : COVERAGES CERTIFICATE NUMBER CL1752417810 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. INSR LTR TYPE OF INSURANCE A UBR POLICY NUMBER EFF MMIDDIYYYY MMLDD/POLICY XP YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE I OCCUR I DAMAGE TO RENTED PREMISES Ea occurrence $ 300,000 X MED EXP (Any one person) $ 10,000 —XI PD Ded:500 DTCOIJ14711APHX17 2/18/2017 2/18/2018 PERSONAL & ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 2 , 000 , 000 POLICY LJ X PRO F_�LOC JECT $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Eaaccident $ 1,000,000 BODILY INJURY (Per person) $ B X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS X AUTOS BA1114711A17CNS 2,18,2017 2,18120111 BODILY INJURY Per accident) $ PROPERTY DAMAGE Per accident $ $ X Drive Other Car X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 8,000,000 RDED AGGREGATE $ 8� 000 B EXCESS LIAB CLAIMS -MADE I X I RETENTION$ 10,000 $ CUP1J2532431726 2/18/2017 2/18/2018 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Y❑ (Mandatoryr,NH) N f A 1452910 6/1/2017 6/1/2018 TH- g STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1 000 000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: College & Prospect Intersection Improvements #8318 City of Fort Collins, its officers, agents, and employees, are listed as Additional Insureds as respects General Liability and Auto Liability. Insurance is primary and non-contributory. A 30-day written notice of cancellation applies. CERTIFIUATE HULUEK I.AIVt,tLLAIIUIN City of Fort Collins Purhasing Department PO Box 580 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 ACORD 25 (2014/01) INS025 0rrt40t i J Winter, CISR/JWINTE © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD