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HomeMy WebLinkAboutROCKY MOUNTAIN RECREATION INC - INSURANCE CERTIFICATE 2023-2024ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH- STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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 rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 7/26/2023 (303) 788-1685 (303) 762-1733 13037 Rocky Mountain Recreation Inc PO Box 620411 Littleton, CO 80162 10677 41190 A 1,000,000 X CSU0040682 8/10/2023 8/10/2024 100,000 1,000 1,000,000 2,000,000 2,000,000 1,000,000B X EBA0178279 8/10/2023 8/10/2024 1,000,000A CSU0192249 8/10/2023 8/10/2024 1,000,000 C 4189358 8/1/2023 8/1/2024 1,000,000 1,000,000 1,000,000 B Equipment Floater EBA0178279 8/10/2023 300,000 8864 PLAYGROUND EQUIPMENT REDESIGN AND CONSTRUCTION FOR LIBRARY PARK City of Fort Collins, its officers, agents and employees are named as additional insured with respect to general liability and auto liability. The insurance evidenced by this Certificate will not reduce coverage or limits and will not be cancelled, except after thirty (30) days written notice has been received by the City of Fort Collins City of Fort Collins Financial Services - Purchasing Div PO Box 580 Fort Collins, CO 80522 ROCKMOU-94 JENNIFEREN Mountain West Insurance - Englewood 3575 S Sherman Street Englewood, CO 80113 Jennifer Engerman jenniferen@mtnwst.com The Cincinnati Specialty Underwriters Insurance Company Cincinnati Insurance Company Pinnacol Assurance Aggregate 8/10/2024 X X X X X X Includes copyrighted material of ISO AA 288 06 20 Properties,Inc., with its permission.Page 1 of 4 THIS ENDORSEMENT CHANGES THE POLICY. PLE ASE READ IT CAREFULLY. Ci nciPlus® BUSINESS AUTO XC+® (EXPAN DED COVERAGE PLUS) ENDORSEMENT This endorsement modifies insurance provided by the following: BUSINESS AUTO COVERAGE FORM With respect to the coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by this endorsement. A.Blanket Waiver of Subrogation SECTION IV -BUSINESS AUTO CONDI- TIONS,A.Loss Conditions, 5.Transfer of Rights of Recovery Against Others to Us is amended by the addition of the following: We waive any right of recovery we may have against any person or organization because of payments we make for "bodily injury"or "property damage"arising out of the operation of a covered "auto"when you have assumed liability for such "bodily injury"or "property damage"under an "insured contract",provid- ed the "bodily injury"or "property damage"oc- curs subsequent to the execution or the "in- sured contract". B.Noncontributory Insurance SECTION IV -BUSINESS AUTO CONDI- TIONS,B.General Conditions,5.Other In- surance c.is deleted in its entirety and re- placed by the following: c.Regardless of the provisions of Par- agraph a.above,this Coverage Form's Liability Coverage is primary and we will not seek contribution from any other insurance for any lia- bility assumed under an "insured contract"that requires liability to be assumed on a primary noncontributo- ry basis. C.Additional Insured by Contract SECTION II -LIABILITY COVERAGE,A. Coverage,1.Who is an Insured is amended to include as an insured any person or organi- zation for whom you have agreed in a valid written contract to provide insurance as af- forded by this policy. This provision is limited to the scope of the valid written contract. This provision does not apply unless the valid written contract has been: 1.Executed prior to the accident causing "bodily injury"or "property damage"; and 2.Is still in force at the time of the "accident" causing "bodily injury"or "property dam- age". D.Employee Hired Au to 1.Changes in Liability Coverage The following is added to the SECTION II -LIABILITY COVERAGE,A.Coverage, 1.Who is an Insured: An "employee"of yours is an "insured" while operating an "auto"hiredor rented under a contract or agreement in that "employee's"name,with your permission, while performing duties related to the conduct of your business. 2.Changes in General Conditions SECTION IV -BUSINESS AUTO CON- DITIONS,B.General Co nditions,5. Other Insurance is deleted in its entirety and replaced by the following: b.For Hired Auto Physical Damage Coverage the following are deemed to be covered "autos"you own: (1)Any covered "auto"you l ease, hire, rent or b orrow;and (2)Any covered "auto"hiredor rented by your "employee"under a contract in that individual"em- ployee's"nam e,with your per- mission,while performing duties related to the conduct of your business. Includes copyrighted material of ISO AA 288 06 20 Properties,Inc., with its permission.Page 2 of 4 However,any "auto"that is leased, hired,rented or borrowed with a driver is not a covered "auto". E.Audio,Visual and Data Electronic Equip- ment SECTION III -PHYSICAL DAMAGE COV- ERAGE,C.Limit of Insurance is amended by adding the following: 4.The most we will pa y for all "loss"to au- dio, visual or data electronic equipment and any accessories used with this equipment as a result of any one "acci- dent"is the lesser of: a.The actual cash value of the dam- aged or stolen property as of the time of the "accident"; b.The cost of repairing or replacing the damaged or stolen property with oth- er property of like kind and quality; or c.$2,500. Provided the equipment, at the time of the "loss"is: a.Permanently installed in or upon the covered "auto"in ahousing,opening or other location that is not normally used by the "auto"manufacturer for the installation of such equipment; b.Removable from a permanently in- stalled housing unit as described in Paragraph 2.a.above; or c.An integral part of such equipment. F.Who is an Insured -Amended SECTION II -LIABILITY COVERAGE,A. Coverage, 1.Who is an Insured is amended by adding the following: The following are "insureds": 1.Anysubsidiary which is a legally incorpo- rated entity of which you own a financial interest ofmore than 50%of the voting stock on the effective date of this cover- age form. However,the insurance afforded by this provision does not apply to any subsidiary that is an "insured"under any other au- tomobile liability policy or would be an "in- sured"under such policy but for termina- tion of such policy or the exhaustion of such policy's limits of insurance. 2.Any organization that is ne wly acquired or formed by you and over which you main- tain majority ownership.The insurance provided by this provision: a.Is effective on the date of acquisition or formation,and is afforded for 180 days after such date; b.Does not apply to "bodily injury"or "property damage"resulting from an "accident"that occurred before you acquired or formed the organization; c.Does not apply to any newl y acquired or formed organization that is a joint venture or partnership; and d.Does not apply to an insured under any other automobile liability policy or would be an insured under such a policy but for the termination of such policy or the exhaustion of such poli- cy's limits of insurance. 3.Any of your "employees"while using a covered "auto"in your business or your personal affairs,provided you do not own, hire or borrow that "auto". G.Liability Coverage Extensions -Supple- mentary Payments -Higher Limits SECTION II -LIABILITY COVERAGE,A. Coverage,2.Coverage Extensions,a.Sup- plementary Payments is amended by: 1.Replacing the $2,000 Limit of Insurance for bail bonds with $4,000 in (2); and 2.Replacing the $250 Limit of Insurance for reasonable expenses with $500 in (4). H.Amended Fellow Employee Exclusion SECTION II -LIABILITY COVERAGE,B.Ex- clusions,5.Fellow Employee is modified as follows: Exclusion 5. Fellow Employee is deleted. I.Hired Auto -Physical Damage If hired "autos"are covered "autos"for Liability Coverage,then Comprehensive and Collision Phys ical Damage Coverages as provided un- der SECTION III -PHYSICAL DAMAGE COVERAGE of thisCoverage Part are ex- tended to "autos"you hire,subject to the fol- lowing: 1.The most we will pay for "loss"to any hired "auto"is $50,000 or the actual cash value or cost to repair or replace,which- ever is the least, minus a deductible. 2.The deductible will be equal to the largest deductible applicable to any owned "auto" for that coverage,or $1,000,whichever is less. 3.Hired Auto -Phys ical Damage coverage is excess over any other collectible insur- ance. Includes copyrighted material of ISO AA 288 06 20 Properties,Inc., with its permission.Page 3 of 4 4.Subject to the above limit,deductible,and excess provisions we will provide cover- age equal to the broadest coverage appli- cable to any covered "auto"you own in- sured under this poli cy. Coverage includes loss of use of that hired au- to,provided it results from an "accident"for which you are legally liable and as a result of whicha m onetary lossissustained by the leasing or rental concern.The most we will pay for any one "accident"is $3,000. If a limit for Hired Auto -Phys ical Damage is shown in the Schedule,then that limit replac- es,and is not added to,the $50,0 00 limit indi- cated above and the deductibles shown in the Schedule are applicable. J.Rental Reimbursement SECTION III -PHYSICAL DAMAGE COV- ERAGE is amended b y adding the followin g: 1.We will pa y for rental reimbursement ex- penses incurred by you for the rental of an "auto"because of a "loss"to a covered "auto".Payment applies in addition to the other wise applicable amount of each cov- erage you have on a covered "auto".No deductible applies to this coverage. 2.We will pay only for those expenses in- curred during the policy period beginning 24 hours after the "loss"and ending,re- gardless of the policy's expiration,with the lesser of the following number of days: a.The number of days reasonably re- quired to repair the covered "auto". If "loss"is caused by theft,this number of days is added to the number of days it takes to locate the covered "auto"and return it to you; or b.30 days. 3.Our payment is limited to the lesser of the following amounts: a.Necessary and actual expenses in- curred; or b.$50 per day. 4.This coverage does not apply while there are spare or reserve "autos"available to you for your operations. 5.We will pay under this coverage only that amount of your rental reimbursement ex- penses which is not already provided for under SECTION III -PHYSICAL DAM- AGE COVERAGE,A.Coverage,4. Coverage Extensions. K.Transportation Expense -Higher Limits SECTION III -PHYSICAL DAMAGE COV- ERAGE,A.Coverage, 4.Coverage Exten- sions is amended by replacing $20 per day with $50 per day,and $600 maximum with $1,500 maximum in Extension a.Transpor- tation Expenses. L.Airbag Coverage SECTION III -PHYSICAL DAMAGE COV- ERAGE,B.Exclusions,3.a.is amended by adding the following: However,the mechanical and electrical breakdown portion of this exclusion does not apply to the accidental discharge of an airbag. This coverage for airbags is excess over any other collectible insurance or warranty. M.Loan or Lease Gap Coverage 1.SECTION III -PHYSICAL DAMAGE COVERAGE,C.Limit of Insurance is deleted in its entirety and replaced by the following,bu t only for private passenger type "autos"with an original loan or lease, and only in the event of a "total loss"to such a private passenger type "auto": a.The most we will pay for "loss"in any one "accident"is the greater of: (1)The amount due under the terms of the leaseor loan to which your covered private passenger type "auto"is subject,but will not include: (a)Overdue leaseor loan pay- ments; (b)Financial penalties imposed under the lease due to high mileage,excessive useor abnormal wear and tear; (c)Security deposits not re- funded by the lessor; (d)Costs for extended warran- ties,Credit Life Insurance, Health,Accident or Disabil- ity Insurance purchased with the loan or lease; and (e)Carry-over balances from previous loans or leases, or (2)Actual cash value of the stolen or damaged property. b.An adjustment for depreciationand physical condition will be made in de- termining actual cash value at the time of "loss". Includes copyrighted material of ISO AA 288 06 20 Properties,Inc., with its permission.Page 4 of 4 2.SECTION V -DEFINITIONS is amended by adding the following,bu t only for the purposes of this Loan or Lease Gap Coverage: "Total loss"means a "loss"in which the cost of repairs plus the salvage value ex- ceeds the a ctual cash value. N.Glass Repair -Waiver of Deductible SECTION III -PHYSICAL DAMAGE COV- ERAGE,D.Deductible is amended by adding the following: No deductible applies to glass damage if the glass is repaired in a manner acceptable to us rather than replaced. O.Duties in the Event of an Accident,Claim, Suit or Loss -Amended SECTION IV -BUSINESS AUTO CONDI- TIONS,A.Loss Conditions,2.Duties in the Event of Accident,Claim,Suit or Loss,a.is amended by adding the following: This condition applies only when the "acci- dent"or "loss"is known to: 1.You, if you are an individual; 2.A partner, if you are a p artnership; 3.An executive officer or insur ance manag- er,if you are a corporation; or 4.A member or ma nager,if you are a lim- ited liability company. P.Unintentional Failure to Disclose Hazards SECTION IV -BUSINESS AUTO CONDI- TIONS,B.General Conditions,2.Conceal- ment,Misrepresentation or Fraud is amended by adding the following: However, if you unintentionally fail to disclose any hazards existing on the effective date of this Co verage Form,we will not deny cover- age under this Coverage Form because of such failure. Q.Mental Anguish Resulting from Bod ily Inju- ry SECTION V -DEFINITIONS,C."Bodily inju- ry"is deleted in its entirety and replaced by the following: "Bodily injur y"means bodil y injury,sickness or disease sustained b y a person,including men- tal anguish and death susta ined by the same person that results from such bodil y injur y, sickness or disease."Bodily injury"does not include mental anguish or death that does not result from bodily injury, sickness or disease. R.Coverage for Certain Operations in Con- nection with Railroads With respect to the use of a covered "auto "in operations for or affecting a railroad: 1.SECTION V -DEFINITIONS,H."Insured contract",1.c.is deleted in its entirety and replaced b y the following: c.An easement or license agreement; 2.SECTIONV -DEFINITIONS,H."Insured contract",2.a.is deleted. Includes copyrighted material of ISO CSGA 437 12 13 Properties, Inc., with its permission.Page 1 of 2 COMMERCIAL GENERAL LIABILITY CSGA 437 12 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS,LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU - OPERATIONS AND COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A.SECTION II -WHO IS AN INSURED is amended to include as an additional insured any person or organization when you and such person or organization have agreed in writing in a contract or agreement that such person or organization be added as an additional insured on your policy,but only with respect to "bodily injury", "property damage" or "personal and advertising injury"caused,in whole or in part, by: 1.Your acts or omissions in the perform- ance of your ongoing operations for the additional insured; 2.The acts or omissions of those acting on your behalf in the performance of your ongoing operations for the additional in- sured; or 3."Your work" performed for the additional insured and included in the "products- completed operations hazard". If not specified otherwise in the written con- tract or agreement, a person's or organiza- tion's status as an additional insured under this endorsement ends one year after your opera- tions for that additional insured are completed. The written contract or agreement must be currently in effect or become effective during the term of this Coverage Part. The contract or agreement must be executed prior to the "bod- ily injury", "property damage"or "personal and advertising injury" to which this endorsement pertains. However: 1.The insurance afforded to such additional insured only applies to the extent permit- ted by law; and 2.If coverage provided to the additional in- sured is required by a contract or agree- ment, the insurance afforded to such ad- ditional insured will not be broader than that which you are required by the con- tract or agreement to provide for such ad- ditional linsured. B.W ith respect to the insurance afforded to these additional insureds, the following addi- tional exclusions apply: This insurance does not apply to: 1."Bodily injury", "property damage"or "per- sonal and advertising injury"arising out of the rendering of,or the failure to render, any professional architectural, engineer- ing or surveying services, including: a.The preparing, approving, or failing to prepare or approve,maps, shop drawings, opinions, reports, surveys, field orders, change orders or draw- ings and specifications; or b.Supervisory, inspection, architectural or engineering activities. 2."Bodily injury"or "property damage" aris- ing out of "your work" for which a consoli- dated (wrap-up)insurance program has been provided by the prime contrac- tor/project manager or owner of the con- struction project in which you are involved. 3."Bodily injury", "property damage"or "per- sonal and advertising injury" to any em- ployee of you or to any obligation of the additional insured to indemnity another because of damages arising out of such injury. Includes copyrighted material of ISO CSGA 437 12 13 Properties, Inc., with its permission.Page 2 of 2 4."Bodily injury", "property damage"or "per- sonal and advertising injury" for which the Named Insured is afforded no coverage under this policy of insurance. C.W ith respect to the insurance afforded to these additional insureds, SECTION III -LIM- ITS OF INSURANCE is amended to include: The limits applicable to the additional insured are those specified in the written contract or agreement or in the Declarations of this Cov- erage Part, whichever is less. If no limits are specified in the written contract or agreement, the limits applicable to the additional insured are those specified in the Declarations of this Coverage Part.The limits of insurance are in- clusive of and not in addition to the limits of in- surance shown in the Declarations. D.With respect to the insurance afforded to these additional insureds, SECTION IV - COMMERCIAL GENERAL LIABILITY CON- DITIONS,4. Other Insurance is amended to include: Any coverage provided herein will be excess over any other valid and collectible insurance available to the additional insured whether primary, excess, contingent or on any other basis unless you have agreed in a written con- tract or written agreement executed prior to any loss that this insurance will be primary. This insurance will be noncontributory only if you have so agreed in a written contract or written agreement executed prior to any loss and this coverage is determined to be primary.