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HomeMy WebLinkAbout479201 HEATH CONSTRUCTION - INSURANCE CERTIFICATE (8)ACORO" CERTIFICATE OF LIABILITY INSURANCE F9TE 15//D20117m 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: IMA, inc. - Colorado Division PHONE FAX No: E-MAIL DenACCOM=tTOChg@'MaCOrp.COM ADDRESS: 1705 17th Street INSURERS AFFORDING COVERAGE NAIL i suite 100 INSURERA:CH►RTER OAR FIRE INS CO(Travelers) 25615 Denver, Co 80202 INSURED INSURER B: TRAMET"S IND CO 25658 INSURER CTRAVELERS PROP CAS CO OF AMM 25674 Heath Construction, LLC INSURER 0:PINHACOL ASSUR 141190 141 Racquette Drive P.O. Box Drawer H INSURERE: 1 INSURERF: Port Collins, CO 80522 PnVFDA!_FC r_FRTIFIr`ATF N1iURFR• 50785554 REVISION NUURFR- 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. ILTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MMIDDPOLICYEFF LTR NsRA /YYYY MWDOY EXP LIMITS X COMMERCIAL GENERALLtABILITY DTC07F694337COF16 04/30/17 04/30/18 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE rx]OCCUR PREMISES Ea occurrence) f 300,000 _ MED EXP (Any one person) f 5,000 $5, 000 PD Deductible PERSONAL 8ADVINJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY [�] JECT 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) i ANY AUTO BODILY INJURY (Per accident) f ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED AUTOS A AUTOS Ix PROPERTY DAMAGEHIRED (Par., $ $ C UMBRELLA LIAB Z OCCUR CU74J02027A1726G 04/30/17 04/30/18 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 _Ej EXCESSLNB CLAIMS -MADE DED RETENTION f D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE Y / N OFFICERIMEMBER EXCLUDED? N❑ (Mandatory In NH) N / A 3096125 - Colorado 10/01/17 10/01/18 PER OTH- = STATUTE I I E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT f 1,000,000 It es, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If 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. GLK 1 WIUA It MULUtK iL FU I%,CLLJ%1 IUM RE: 7675 South Transit Center - Bike Shelter Addition. ty of Fort Collins 300 Laporte Ave. Collins, CO 80522 USA 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 © 1985-2014 ACORD CORPORATION. All rights reservea. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD francine 50785554 w O N �P526W2a1N)2 ACOR" CERTIFICATE OF LIABILITY INSURANCE 09/15/20D17n 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: INA, Inc. - Colorado Division PHONE FAX No): E-MAIL DenAccountTechsQimacorD.com 1705 17th Street ADDRESS: Suite 100 _ INSURE S AFFORDING COVERAGE NAIC8 Denver, CO 80202 INSURERA: CHARTER OAK FIRE INS CO(Travelers) 25615 INSURED INSURERS: TRAVELERS IND CO 25658 Heath Construction, LLC INSURER CTRAVELHRS PROP CAS CO OF AI= 25674 141 Racquette Drive INSURERD: PnRMML ASSUR 41190 P.O. Box Drawer H INSURER E: FOrt Collins, CO 80522 1 INSURER F: rnV1C0A/_Cc /`CDTICIf ATC MIINIRCR- 5117RSShc RFVIRIAN NIINIRFR- 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 LTRWVD TYPE OF INSURANCE ADOL SUER POLICY NUMBER MMIDDPOLICY EFF M M`i DI EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR $5,000 PD Deductible DTC07F694337COF16 04/30/17 04/30/18 EACH OCCURRENCE $ 1,000,000 DG1TED PREM SES- Ewa occurrence) $ 300,000 X MEDEXP(Aryone person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEML AGGREGATE LIMIT APPLIES PER: POLICY LJ JEC7 EILOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS. COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY z ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED E HIRED AUTOS X: AUTOS DT8107F794337TIL17 04/30/17 04/30/18 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) _ $ BODILY INJURY (Per acmdeM) $ PROPERTY DAMAGE Per accident $ $ C E UMBRELLA I" EXCESS LIAR IJ�_CU,',CVP4ao2027A1726G ADE 04/30/17 04/30/18 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10, 000, 000 DED RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE Y I N OFFICERIMEMBER EXCLUDED? N❑ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 3096125 - Colorado 10/01/17 10/01/18 H X STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1 $ 1,000.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace Is r"ulred) ,`GOTRI,`ATC UnI MCO rAMCFI 1 ATInM RE: Contractor License. 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. Attn: Delynn COldiron PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522-0580 /�/�� / ///& USA LLL[ / U 198a-ZU14 AGUKU GUKYUKA I IUN. All ngnts reservea. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD francine 50785544