2018-09-18_PERMIT FILE - M2018048

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AcoRo® CERTIFICATE OF LIABILITY INSURANCE 4/1/2019 /2 D 5/23/201`Y'" Y"' 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 poliey(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terns 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 endorseme s. PRODUCER Lockton Companies .__ 8110 E�Union Avenue PHONE FAX J- Suite 700 iidan Denver CO 80237 (303)414-6000 INSURERS)AFFORDING COVERAGE NAIC 8 11150 INSURED SEMA Construction,Inc. INSURER a.National Fire and Marine Insurance Co 20079 1347436 7353 South Eagle Street INSURER c:Illinois Union Insurance CooWa y_ ^_ 27960 Centennial,CO 80112 INSURER D: INSURER E: INSURER : COVERAGES CERTIFICATE NUMBER: 15401810 REVISION NUMBER: XXXXXXX 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. J:1 TYPE OF INSURANCE POLICY NUMBER POLICY OF LIINTe -- - - A COMMERCIAL GENERAL LIABILITY y Y j 71 PK089974 4/1/2018 4/1/2019 LEACH OCCURRENCE I�000,000- CLAIMS MADE OCCUR ( F MI5 S IF xrgrrpeL_Y S 500,)00 �MED EJfP(A^Yare Peram) J 10,000 - '— PERSONAL a ADV INJURY s 2,00t0 QW-- +GENL AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE 3 4 000,000 POLICY�JJEECT ❑LOC i PRODUCTS_COMPIOP AGG s 4000,000 _-_ OTHER: � --- ---- -- E A I AOTOWHMELIABILITY Y Y 71PKG89974 4/1/2018 1 4/1/2019 1 COM SINGLE LIMIT_ $ 2,000,000 X ANY AUTO ! l BODILY INJURY(Per person) $ XXXXXXX OWNED SCHEDULED BODILY INJURY(Per acdd� ; AUTOS ONLY AUTOS XXXXXXX___ X HIRED NON-OWNE AUTOS ONLY X AUTOSY ��a1DAMAti — s �{ —I S X KXXXXX — B X UMBRELLA LIAR pCCUq Y Y 42XSF302394 4/1/2018 4/1/2019 EACH OCCURRENCE ,s 25.000,000 -EXCESS LIA9 _I ICLA_I_M__S_-_MADE{ AGGREGATE------ --- - S 25,000iODO _ DED RETENTIONS ' ' E XXXXYM p WORKERS PLO g�u COMPENSATION y 1 71 WCI88973-AOS '4/112018 411/2019 X_STATVT_,__ ,ER" _ - A ANY PROPRIETOMPARTNERIEXECUTIVE Y/N I ? 74WC189362-CA,TX 14/l/2018 4/1/2019 E.L EACH ACCIDENT i1 E 1-0(1 QQQ- OFFICERIMEMSER EXCLUDED] a.N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOY S 1.()DQ•DQQ_ H yes,deaatbe under DESCRIPTION OF ERATIONS bebw El DISEASE-POLICY LIMB i; .090,000 C 1 Prof/Poll Liability ! Y Y G2726778600 4/1/2018 4/112019 SIM Do=/$I0M agg Prof ` s5M Pollution 1 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional R*marks Schedukk nosy be MaChad N more span Is requrrsd) RE:SEMA Project#101808.North I-25 Express Lanes-Project#IM 0253-255(21506). Kraemer/IHC Joint Venture,CDOT,and their trustees,officers, affiliates(including but not limited to joint ventures),agents and employees are included as Additional Insured as respects General,Auto,Umbrella,and Pollution Liability as required by written contract Coverage is primary and non-contributory. Waiver of Subrogation applies in favor of Additional insured as required by written contract. CERTIFICATE HOLDER CANCELLATION See Attachments 15401810 Kraemer/IHC Joint Venture SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 900 West Castleton Road, THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Suite 220 Castle Rock,CO 80109 AUTNORIZED REPRES A 0 1988 015 ACORD CORP AT10N. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD