HomeMy WebLinkAboutHALL-IRWIN CORPORATION - INSURANCE CERTIFICATEDATE (MM/DD/YYYY)
ACORO� CERTIFICATE OF LIABILITY INSURANCE
�� 12/29/2023
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).
PRODUCER CONTACT
_NAME: Katie Smothers
CRS Insurance Brokerage PFiONE FAX
9780 S Meridian Blvd Suite 400 A/C No eXr : 303-996-7800 Aic No : 303-757-7719
Englewood CO 80112 ao�a�ess: ksmothers crsdenver.com
INSURER(S) AFFORDING COVERAGE NAIC #
INSURERA Westfield Insurance 24112
INSURED HALIR-1 INSURER 6: PIf11laCOI ASSUf2f1C2 41190
Hall-Irwin Corporation
5586 W 19th St., Suite 2000 iNsuReRc: United S ecialt Insurance Co 12537
Greeley CO 80634 INSURER D:
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER:264746007 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 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 EFF ' POLICY EXP " LIMITS
LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY
C X COMMERCIAL GENERAL LIABILITY Y ATN2397928 12/31/2023 12/31/2024 EACH OCCURRENCE �$ 1,000,000
I CLAIMS-MADE � X � OCCUR � DAMAGE TO RENTED �
_ „ , PREMISES (Ea occurrence) $ SQ000
MED EXP (Any one person) .$ 5,000
X WY EL Stop Gap � PERSONAL & ADV INJURY I$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: � GENERAL AGGREGATE I$ 2,000,000
�POLICY I, X I ECT I I LOC PRODUCTS - COMP/OP AGG $ 2,000,000
OTHER: Stop Gap Liability $ 1,000,000
A AUTOMOBILELIABILITY Y CWP7976721 � 12/31/2023 12/31/2024 COMBINED SINGLE uMIT � g �,000,000
_La accideM� .
X ANY AUTO BODILY INJURY (Per person) $
OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS ONLY � AUTOS
X HIRED X NON-OWNED I� PROPERTY DAMAGE $
. AUTOS ONLY AUTOS ONLY ,. .(Per accident). �..
$
C_ I UMBRELLA LIAB � pCCUR BTN2391042 12/31/2023 12/31/2024 EACH OCCURRENCE $ 5,000,000
X I EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000
I� DED X � RETENTION $ � $
g WORKERSCOMPENSATION 4021105 1/1/2024 1/1/2025 IX I PER - - OTH- I
AND EMPLOYERS' LIABILITY Y� N _ STATUTE _ _, ER
ANYPROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT �� $ 1,000,000
OFFICER/MEMBEREXCLUDED? � N�A � —
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEEI $ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I$ 1,000,000
A� Leased and Rented Equipment CWP7976721 � 12/31/2023 12/31/2024 � Limit 1,000,000
SpecialForm/ACV/100% Coinsurance Deductible 2,500
DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
City of Fort Collins is included as additional insured for ongoing operations on the General Liability and included as additional insured on the Auto Liability with
respect to operations of the named insured for the certificate holder as required by written contract.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Fort Collins
P. O Box 580
Fort Collins CO 80522
ACORD 25 (2016/03)
AUTHORIZED REPRESENTATIVE
� C4'�Mtiwil
O 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
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V V � SM
Li�� S E h I ES
BUSINESS AUT4 ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
SCHEDULE
The coverage provided by this endorsement is summarized below and is intended to provide a general
coverage description only. For the details affecting each coverage, please refer to the terms and condi-
tions in this endorsement.
A. Who Is An Insured broadened:
• Additional Insured by Contract, Agreement or Permit
• Legally Incorporated Subsidiaries
. Newly Acquired Organizations
B. Supplementary Payments
• Bail Bonds - $5000
• Loss of Earnings - $500
C. Fellow Employee Exclusion Amendment
D. Coverage E�ensions
• Transportation Expenses
. Personal Effects (Excess Basis)
E. Additional Coverages
• Expenses paid for returning a stolen covered auto
• Fire Department Service Charge
F. Airbag Coverage - Accidental Discharge
G. Glass Repair - Waiver of Deductible
H. Knowledge and Notice of an Accident, Claim or Suit
I. Unintentional Failure To Disclose Hazards
J. Worldwide Coverage
K. Definitions
• Bodily Injury Redefined
In addition to the policy amendments contained in A. through K. listed above, the endorsements listed
below will automatically be attached to your policy to complete the coverage provided by the Signature
Series Business Auto Endorsement:
• Audio, Visual and Data Electronic Equipment Coverage Added Limits - CA 99 60
• Auto Loan/Lease Gap Coverage - CA 20 71
• Drive Other Car Coverage - Broadened Coverage For Named Individuals -(Executive
Officers/Spouses) - CA 99 10
• Employee Hired Autos - CA 20 54
• Employees As Insureds - CA 99 33
• Hired Auto Physical Damage (Refer to Auto Declarations page)
• Rental Reimbursement Coverage - CA 99 23
. Waiver of Transfer of Rights of Recovery (Waiver of Subrogation) - CA 04 44
A. WHO IS AN INSURED BROADENED
SECTION II - COVERED AUTOS LIABILITY
COVERAGE, item A. Coverage, 1. Who Is An
Insured is amended to include the following
additional paragraphs:
d. Any legally incorporated subsidiary
of yours in which you own more than
50% of the voting stock on the ef-
fective date of this endorsement.
However, "insured" does not include
any subsidiary that is an "insured"
under any other liability policy or
would be an "insured" under such a
policy but for its termination or the
exhaustion of its limit of insurance.
CA 70 77 10 13
Page 1 of 3
Coverage under this provision is af-
forded only for the first 180 days af-
ter you acquire or form the
organization or until the end of the
policy period, whichever comes first.
e. Any organization you newly acquire
or form, other than a partnership or
joint venture, and over which you
maintain ownership or a majority in-
terest. However, coverage under
this provision:
(1) Does not apply if the organiza-
tion you acquire or form is an
"insured" under another auto li-
ability policy or would be "in-
sured" under such a policy but
for its termination or the ex-
haustion of its limits of insur-
ance;
(2) Does not apply to "bodily injury"
or "property damage" that oc-
curred before you acquired or
formed the organization; and
(3) Is afforded only for the first 180
days after you acquire or form
the organization or until the end
of the policy period, whichever
comes first.
Any person or organization with
whom you agreed in writing in a
contract, agreement or permit, to
provide insurance such as is af-
forded under this policy.
This provision only applies if the
written contract or agreement has
been executed or permit has been
issued, prior to the "bodily injury" or
"property damage".
B. SUPPLEMENTAL PAYMENTS
SECTION II - COVERED AUTOS LIABILITY
COVERAGE, item A. Coverage, 2. Coverage
Extensions, a. Supplementary Payments, sub-
paragraphs (2) and (4) are deleted and re-
placed with the following:
(2) Up to $5,000 for cost of bail
bonds (including bonds for re-
lated traffic law violations) re-
quired because of an "accident"
we cover. We do not have to
furnish these bonds.
(4) All reasonable expenses in-
curred by the "insured" at our
request, including actual loss of
earnings up to $500 per day be-
cause of time off from work.
C. FELLOW EMPLOYEE EXCLUSION AMEND-
MENT
SECTION II - COVERED AUTOS LIABILITY
COVERAGE, item B. Exclusions, 5. Fellow
Employee does not apply if the "bodily injury"
results from the use of a covered "auto" you
own or hire.
D. COVERAGE EXTENSIONS
SECTION III - PHYSICAL DAMAGE COVER-
AGE, Item A. Coverage, 4. Coverage Exten-
sions, a. Transportation Expenses is replaced
with the following:
a. Transportation Expenses
We will pay up to $100 per day to a
maximum of $1,800 for transporta-
tion expense incurred by you be-
cause of the total theft of a covered
"auto" of the private passenger type.
We will pay only for those covered
"autos" for which you carry either
Comprehensive or Specified Causes
of Loss Coverage. We will pay for
transportation expenses incurred
during the period beginning 48 hours
after the theft and ending, regardless
of the policy's expiration, when the
covered "auto" is returned to use or
we pay for its "loss".
The following is added to Item 4. Cover-
age Extensions:
c. Personal Effects
We will pay up to $500 for the "loss"
of your personal effects that are
contained in a covered "auto" due to
the total theft of the covered "auto."
We will pay only for those personal
effects that are contained in covered
"autos" for which you carry either
Comprehensive or Specified Causes
Of Loss Coverage.
Our payment for "loss" of or damage
to personal effects will apply only on
an excess basis over other collect-
ible insurance.
E. ADDITIONAL COVERAGES
SECTION III - PHYSICAL DAMAGE COVER-
AGE, A. Coverage, is amended to include the
following additional coverage items:
5.
6.
We will pay the expense of returning a
stolen covered "auto" to you.
Fire Department Service Charge
When a fire department is called to save
or protect a covered "auto", its equip-
ment, its contents or occupants from a
Covered Cause Of Loss, we will pay up
to $1,000 for your liability for Fire De-
partment Service Charges:
CA 70 77 10 13
Page 2 of 3
(a) Assumed by contract or agreement
prior to loss; or
(b) Required by local ordinance.
No deductible applies to this additional
coverage.
F. AIRBAG COVERAGE - ACCIDENTAL DIS-
CHARGE
SECTION III - PHYSICAL DAMAGE COVER-
AGE, Item B. Exclusions, subparagraph 3.a.
is deleted and replaced with the following:
a. Wear and tear, freezing, mechanical
or electrical breakdown.
Mechanical breakdown does not ap-
ply to the accidental discharge of an
airbag.
G. GLASS REPAIR - WAIVER OF DEDUCTIBLE
SECTION III - PHYSICAL DAMAGE COVER-
AGE, item D. Deductible the following para-
graph is added:
No deductible shall apply to glass dam-
age if the glass is repaired rather than
replaced.
H. KNOWLEDGE AND NOTICE OF AN ACCI-
DENT, CLAIM OR SUIT
SECTION IV - BUSINESS AUTO CONDITIONS,
Item A. Loss Conditions is amended as fol-
lows:
Subparagraph a. under Item 2. Duties In
The Event Of Accident, Claim, Suit Or
Loss, is amended to include the following
paragraphs:
This requirement applies when the
"accident," claim, "suit" or "loss" is
first known to:
(1) You, if you are an individual;
(2) A partner, if you are a partner-
ship; or
(3) An executive officer or insur-
ance manager, if you are a cor-
poration.
Subparagraph b.(2) under 2. Duties In
The Event Of Accident, Claim, Suit Or
Loss is amended as follows:
(2) Immediately send us copies of
any request; demand, order,
notice, summons or legal paper
received concerning the claim
or "suit."
Your employees may know of
documents received concerning
a claim or "suit". This will not
mean that you have such know-
ledge, unless receipt of such
documents is known to you, any
of your executive officers or
partners or your insurance
manager.
UNINTENTIONAL FAILURE TO DISCLOSE
HAZARDS
Under SECTION IV - BUSINESS AUTO CON-
DITIONS, B. General Conditions, 2.
Concealment, Misrepresentation Or Fraud is
amended to include the following additional
paragraph:
If you unintentionally fail to disclose any
hazards existing at the inception date of
your policy, we will not deny coverage
under this Coverage Part because of
such failure.
J. WORLDWIDE COVERAGE
Under SECTION IV - BUSINESS AUTO CON-
DITIONS, B. General Conditions, 7. Policy
Period, Coverage Territory, subparagraph (5)
is deleted and replaced with the following:
(5} Anywhere in the world, if:
(a) A covered "auto" of the private
passenger type is leased, hired,
rented or borrowed without a
driver for a period of 45 days or
less; and
(b) The "insured's" responsibility to
pay damages is determined in
a"suit" on the merits, in the
United States of America,
Puerto Rio or Canada or in a
settlement we agree to.
(c) If, for such "autos" a"suit" is
brought outside the territory de-
scribed in 7.(1} through 7.{4}
above, we will reimburse the
insured for defense expenses
incurred with our written con-
sent, but we will make no pay-
ment. nor will we reimburse the
insured for damages.
K. DEFINITIONS
Under SECTION V- DEFINITIONS, Item C. is
replaced by the following:
C. "Bodily injury" means bodily injury, sick-
ness or disease sustained by a person,
including mental anguish, mental injury
or death resulting from any of these.
"Bodily injury" includes mental anguish
or other mental injury resulting from
"bodily injury".
CA 70 77 10 13
Page 3 of 3
Policy Number: ATN2397928
COMMERCIAL GENERAL LIABiLITY
CG 20 10 04 13
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS - SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Or
Organization(s) Loca#ion(s) Of Covered Operations
As required by written contract, fully executed prior to the named As required by written contract, fuliy executed prior to the
insured's work. - ongoing named insured's work. - ongoing
lnformation required to complete this Schedule, if not shown above, will be shown in the �eciarations.
A. Section II — Who Is An Insured is amended to
include as an additionaf insured the persan(s) or
organization(s) shown in the Schedule, but only with
respect to liability for "bodily injury", "property damage"
or "personal and advertising injury" caused, in whole
or in part, by:
L Your acts or omissions; or
2. The acts or omissions of those acting on your behalfi;
in the performance of your ongoing operations for
the additional insured(s) at the location(s)
designa#ed above.
However:
B. With respect to the insurance afforded to these
additional insureds, the following additional exclusions
apply:
This insurance does not apply to "bodily injury" or
"property damage" occurring after:
1. All work, including materials, parts or equipment
furnished in connectian with such work, on the
project (other ihan service, maintenance or repairs)
to be performed by or on behaif of the additional
insured(s) at the location of the covered aperations
has been completed; or
2. That portion of "your work" out of which the
injury or damage arises has been put to its
intended use by any person or orgar�ization other
1. The insurance afiorded to such additional insured only than another contractor or subcontractor engaged
appkies to the extent permitted by law; and in performing operations for a principal as a pa�t of
2. If coverage provided to the additional insured is the same project.
required by a contract ar agreement, the insurance
afforded to such additional insured wiil not be broader
than that which you are required by the contract or
agreement to provide for such additional insured.
CG 20 10 0413 O Insurance Services Office, Inc., 2012 Page 1 of 2
C. With resp�ct to the insurance afforded to
these additional insureds, the following is added to
Section 411— Limits Of Insurance:
If coverage provided to the additional insured ss
required by a contract or agreement, the most we
will pay an behalf of the additional insured is the
amount af insurance:
1. Required by the contract or agreement; or
2. Available under the applicabie Limits of
Insurance shown in the Declarations;
whichever is less.
This endors�ment shall not increase the applicable
Limits of Insurance shown in the Declarations.
F'age 2 of 2 O Insurance Services Offce, Inc., 2012 CG 2010 0413