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HomeMy WebLinkAboutASPEN HEIGHTS CONSTRUCTION LLC - INSURANCE CERTIFICATE (5)rl�e.,*�• oozu� 1AACPPMW ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYr) 7/18/2018 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 have ADDITIONAL INSURED provisions or 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER Wortham Insurance &Risk Mgmt. 221 West 6th Street, Suite1400 CONTACT Shelia Moore, CIC A/ o E.): 512 453-0031 FAX No: 512 453-0041 ADDRESS, Shelia.moore@worthaminsurance.com Austin, TX 78701 INSURER(S) AFFORDING COVERAGE NAIC # 512 453-0031 INSURER A: Hartford Fire Insurance Company 19682 INSURED Aspen Heights Construction, LLC INSURER B : Allied World Assurance Co (U.S.) Inc. 19489 Cincinnati Indemnity Company INSURER C : Y 23280 1301 S. Capital of Texas Hwy Trumbull Insurance Company INSURER D : P Y 27120 Suite B-201 Austin, TX 78746 INSURER E : INSURER F rnvconcGc rGaTII=IreTF MI IIUIRFR• 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 CONTRACTOR 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 TYPE OF INSURANCE ADDLSUB IN R WVD POLICY NUMBER POLICY EFF MM/DD/YYYY) POLICY EXP (MMIDD= LIMITS A X. COMMERCIAL GENERAL LIABILITY 65UEAKQ1720 7/19/2018 07119/2019 EACH OCCURRENCE s2,000,000 PREMISES (E. occurr.nce)$300 000 CLAIMS -MADE 7OCCUR X MED EXP (Any one person) s5,000 PD Ded: $5,000 PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 PRO- _ PRO. LOC POLICY PRODUCTS - COMP/OP AGG $4,000,000 $ OTHER: D AUTOMOBILE LIABILITY _ 65UEAKQ3965 7/19/2018 07/19/201 Eaa acccidentsINGLE LIMIT 1,000,000 BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY PROPERTY DAMAGE Per accident $ B UMBRELLA LIAB OCCUR 03114469 7/19/2018 07119/2019 EACH OCCURRENCE s25,000,000 x X AGGREGATE s25,000,000 EXCESS LIAB CLAIMS -MADE DED I X RETENTION $10000 $ WORKERS COMPENSATION _ PER OTH- JER ---- - AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? NIA E.L. EACH ACCIDENT $_ (Mandatory Ir. NH) E.L. DISEASE - EA. EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below C Rented/Leased Equ ENP0309056 7/19/2018 07/1912019 $2,000,000 limit C Rented/Leased Equ ENP0309056 7/19/2018 07/19/2019 $5,000 deductible DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The General Liability and Auto policy include blanket additional insured endorsements that provide additional insured status to the certificate holder when there is a written contract between the named insured and the certificate holder requiring additional insured status. The General and Excess Liability policies include an endorsement providing 30 days notice of cancellation (or coverage change) furnished to the certificate holder if the policy is cancelled for other than nonpayment of premium; 10 days notice (See Attached Descriptions) CERTIFICA City of Fort Collins RECEIVE[ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 300 LaPorte Ave ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 JUL 2 3 2018 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE City Manager's Offic, © 1988-2015 ACORD CURPURA I IUN. All rlgnts reserVea. ACORD 25 (2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S920267/M920192 14SXM