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HomeMy WebLinkAboutNIXCAVATING INC - INSURANCE CERTIFICATE (6)A/ �� ® DATE (MMIDD/YYYY) V CERTIFICATE OF LIABILITY INSURANCE 9/28/2017 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 endorsements . PRODUCER CONTACT Karole Peters NAME: Ewing -Leavitt Insurance Agency, Inc. PHONE (970) 679-7333 No: (866)456-4265 4090 Clydesdale Parkway ADORIess:karole-MAIL Suite 101 INSURERS AFFORDING COVERAGE NAIC N Loveland CO 80538 INSURERA:Cincinnati Insurance Co 110677 INSURED Nixcavating, Inc. P. O. Box 2232 INSURER D : Longmont CO 80501 1 INSURERF: r•nvGDAr_cc rFDTIFIrATF NI IIUFlFR-17-18 PCGK RENEWAL RFVICIr1N NIIMRFR• 4 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF liDDi POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY EPP0124847 10/1/2017 10/1/2018 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR DAMAGE TO PREMISES (Ea occurrence)t $ 500,000 X MED EXP (Any one person) $ 10,000 Blkt Additional Insured X Blkt Waiver of Subro PERSONALBADVINJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2 , 000 , OOO POLICY RO- LOC CT PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY EPP0124847 10/1/2017 10/1/2018 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS X AUTOS HIRED D X NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ $ X Blkt Al X Blkt WOS A X UMBRELLA LIAB X OCCUR EPP0124847 10/1/2017 10/1/2018 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 EXCESS LIAB CLAIMS -MADE DED I X I RETENTION 0 1 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y� 2113100 1/1/2017 1/1/2018 X ISPER OTH- TATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE —_..--- $ _ 1, 0001000 --- _ ---- OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA A If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I $ 1,000,000 A Lease or Rented Equipment EPP124847 10/1/2017 10/1/2018 Limit with$500 Deductible $220,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is additional insured on the general liability policy as regards work performed by the insured. L:tK l 11-IGA It NULUtK I lull City of Fort Collins 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 role Peters/KAPETE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INCMS ionnn