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HomeMy WebLinkAbout592297 HASELDEN CONSTRUCTION LLC - INSURANCE CERTIFICATENS �,MXI?IGM2 ACORO" CERTIFICATE OF LIABILITY INSURANCE 07//271/2001 DDIYYm 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 terns 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: FAX =h, Inc. - Colorado Division PHONE � -WC" No-.Extl: __ _ IAIC. Nol: denaccounttecho@imacorp.com 1705 17th Street �E-MAIL � S: -- suite 100 INSURE S AFFORDING COVERAGE NAIC r_ Denver, CO 80202 INSURER A: VALLEY FORGE INS CO (CNA) 20508 INSURED INSURERS: CONTINMMAL INS CO(CNA Insurance) 35209 Haselden Construction, LLC INSURER CPINNACOL ASSOR 41190 6950 South Potomac street INSURER D: INSURER E : Centennial, CO 80112 1 INSURERF: cnVFQAGFR CFRTIFICATF NIIMRFR• 50446221 REVISION NIIMRFR: 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. IINSR LTR TYPE OF INSURANCE ADDL 8llBR POLICY NUMBER MAY EFF MMID� E%P UNITS A Z COMMERCIAL GENERAL LIABILITY Z C4028808411 07/01/17 07/01/18 EACH OCCURRENCE :1,000,000 -, CLAIMS -MADE �� OCCUR - DAMAGE TO RENTED PREMISES (Ea occurrence) f 1,000,000 MED EXP (Any one person) = 15,000 Z PD Ded: $10, 000 PERSONAL 4 ADV INJURY S 1,000,000 � _—__----------- AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2. 000, 000 _GENT POLICY PRO- JECT 1XI LOC PRODUCTS - COMP/OP AGG $ 2. 000, 000 _ OTHER: A AUTOMOBILE LIABILITY Z C4028808425 07/01/17 07/01/18 COMBINED SINGLE LIMIT LEa,accident) $ 1,000,000 --- BODILY INJURY (Per person) $ Z ANY AUTO $ ALL OWNED SCHEDULED AUTOS AUTOS — NON -OWNED E HIRED AUTOS $ _ AUTOS BODILY INJURY (Per accident) PROPERTY DAMAGE Per accident): _ $ B Z UMBRELLA LIAB Z OCCUR 6042783626 07/01/17 07/01/18 EACH OCCURRENCE $ 2,000,000 AGGREGATE EXCESS LIAR CLAIMS -MADE i 2,000,000 DED Z RETENTIONS 10,000 i WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) N / A 4082635 - CO ONLY 07/01/17 07/01/18 PERC Z STATUT OR E.L. EACH ACCIDENT t 1,000,000 E.L. DISEASE - EA EMPLOYEd $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 If yes descnbe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCAT'IONS /VEHICLES (ACORN 101, Additional Remarks Schedule, may be attached If mom space Is required) The City, its officers, agents and employees are included as Additional Insureds on the General and Automobile Liabilit Policies if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. CERTIFICATE HULUtK GANGCLL.AIIUN RE: CFC RFP 8546 - CN/GC On -Call. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Purchasing Department PO Box 580 AUTHORIZED REPRESENTATIVE / Fort Collins, CO 80522 / USA Z& 1 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD thcr5350 50446221 RvIk rn 0 �O O N it