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HomeMy WebLinkAbout479201 HEATH CONSTRUCTION LLC - INSURANCE CERTIFICATE (7)AC O IyO� fl CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYV) 04/27/2017 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 1-303-534-4567 IMA, Inc. - Colorado Division CONTACT NAME_: PHONE FAX IALC.Ite EDDRE DenkccountTechBQimacorp.Oom ADDRESS: 1705 17th Street INSURERS AFFORDING COVERAGE NAIC 8 Suite 100 INSURER A: C'ELARTER OAR FIRE INS CO(Travelers) 25615 Denver, CO 80202 _ INSURED INSURER 9: TRAVELERS I= CO 25658 Beath Construction, LLC INSURER CTRAVELERS PROP CAB CO OF AMER 25674 INSURERD: ZURICH AMER INS CO(Pinnacol Assurance) 16535 141 Racquette Drive P.O. Box Drawer H INSURERE: PINKICOL ASHUR 41190 1 INSURERF: Port Collins, CO 80522 COVERAGES CERTIFICATE NUMBER: 49731286 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 OF INSURANCE ADDLTYPE IMSD SUER WVD POLICY NUMBER MMIDDPOLICYNYYYI EFF MMIDD POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY DTC07F694337COFI6 04/30/17 04/30/18 EACH OCCURRENCE $ 1,000,000 J CLAIMS -MADE 1 OCCUR L— DA R MI ES(EaE occurrence) $ 300,000 X MED EXP (Any one person) S 5,000 $5, 000 PD Deductible PERSONAL 6 ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE f 2, 000, OOO GENZ. POLICY [X] JE O- LOC PRODUCTS • COMP/OP AGG $ 2,000,000 $ OTHER. B AUTOMOBILE LIABILITY DT8107F794337TIL17 04/30/17 04/30/18 COMBINED SINGLE LIMIT Ea accident :1,000,000 BODILY INJURY (Per person) f Y ANY AUTO BODILY INJURY (Per eoddent) f ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED AUTOS X HIRED AUTOS rX PROPERTY DAMAGE P er accident) $ $ C Y UMBRELLALIAB N OCCUR CUP4J02027AJ726G 04/30/17 04/30/18 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 EXCESS LIM CLAIMS -MADE DED RETENTION $ $ D E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICERJMEMBER EXCLUDED? � (Mandatory In NH) N I A WC969178406 -Other State 3096125 -Colorado 0/01/16 10/01/16 10/01/17 10/01/17 TH- X STAT TE OER E.L. EACH ACCIDENT f 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 It yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached U more space Is required) City of Fort Collins and State of Colorado are included as Additional Insureds on the General and Automobile Liability Policies if required by written contract or agreement and with respect to work performed by insured subject to the policy terms and conditions. rFRTIFIreTF Hni nFR CANCELLATION RE: 7675 South Transit Center - Bike Shelter Addition. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 300 Laporte Ave. AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 // / /,# USA ©1988-2014 ACORD CORPORATION. All rights reserved. M. ACORD 25 (2014/01) epmaestas 49731286 The ACORD name and logo are registered marks of ACORD