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Home My WebLink About479201 HEATH CONSTRUCTION - INSURANCE CERTIFICATE (14)P52aou2sai2 ACORO® CERTIFICATE OF LIABILITY INSURANCE F -DATE 04/27/20017 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 CONTACT NAME: PHONE FAX No.-Exth INA, Inc. - Colorado Division 1705 17th Street —----- E-MAIL DenACC-tTechs@imacorp.cOs ADDRESS:_ INSURERS AFFORDING COVERAGE NAIC0 Suite 100 INSURERA: CHARTER OAR FIRE INS CO(Travelers) 25615 Denver, CO 80202 INSURED INSURER B: TRAVELERS IND CO 25658 INSURER CTRAVELERS PROP CAS CO OF ASDM 25674 Heath Construction, LLC INSURER0: ZURICH AKER INS CO(PinnacOl Assurance) 16535 141 Racquette Drive INSURERE: PINNACOL ASSUR 41190 P.O. Box Drawer H INSURER F: Fort Collin., CO 80522 COVERAGES CERTIFICATE NUMBER: 49731266 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. INSRLTR LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MMIDD1YYYY POLICY MMIDD EXP LIMITS A Y COMMERCIAL GENERAL LIABILITY DTCO7F694337COF16 04/30/17 04/30/18 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAM AG RENT PREMISES (Ea occurrence) S 300,000 % MED EXP (Any one person) $ 5,000 $5, 000 PD Deductible PERSONAL 3 ADV INJURY $ 1,000.000 _ AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 GENT POLICY JECT LOC PRODUCTS - COMPIOP AGG $ 2,000,000 $ OTHER. B AUTOMOBILE LIABILITY _ DT8107F794337TIL17 04/30/17 04/30/18 COMBINED SINGLE LIMIT Eaccident a $ 1 000,000 � BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Par accdent) $ PIR RTY DAMAGE Peraaiden $ NON -OWNED E HIRED AUTOS AUTOS S C Z UMBRELLALtAB E OCCUR CUP4J02027A1726G 04/30/17 04/30/18 EACHOCCURRENCE S 10,000,000 AGGREGATE $ 10, 000, 000 EXCESS LIAB CLAIMS -MADE DIED RETENTION $ $ D 8 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR(PARTNERIEXECUTIVE � OFFICERIMEMBEREXCLUDED? N (Mandatory in NH) NIA WC969178406 -Other State 3096125 -Colorado 0/01/16 10/01/16 10/01/17 10/01/17 IER PTA UTE R E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS bekm E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached N more space Is required) City of Fort Collins, Admin Services Purchasing Division are included as Additional Insureds on the General Liability Policy if required by written contract or agreement and with respect to work perforated by Insured subject to the policy terms and conditions. UtH I IFIUA I t ty of Fort Collins min Services Purchasing Division PO Box 580 Fort Collins, CO 80522-0580 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 M USA m 1988-2014 ACORD CORPORATION. All rights reserved. M M N ACORD 25 (2014/01) spmaestas 49731266 The ACORD name and logo are registered marks of ACORD