HomeMy WebLinkAbout20001582.tiff ACORD! CERTIFICATE OF LIABILITY INSURANCE.,„P RS DA IE(MM°°/,Y'
CON-2 06/01/00
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Linden/Bartels & Noe Agency-FC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Fort Collins HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
2900 South College Ave Ste. 2A ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW__ _
Fort Collins CO 80525
Phone: 970-229-9304 Fax:970-229-1398 INSURERSAFFORDINGCOVERAGE
INSURED INSURER A. Travelers Indemnity Co__
INSURER B:
Mountain Constructors, INSURER C:
Inc.
P. O. Box 405 INSURER D:
Platteville CO 80651I — ---- - -- -- _-- - - --
INSURER E:
COVERAGES
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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INS POLICVEFFECTIVE- POLICY EXPIRATION LIMITS
LTR TYPE OF INSURANCE POLICY NUMBER ' DATE(MM/DD/YY) DATE(MM/DD/YY)
GENERAL LIABILITY EACH OCCURRENCE $ 1,000 000
A X COMMERCIAL GENERAL LIABILITY DT-CO-161E8703-IND-99 07/28/99 07/28/00 FIRE DAMAGE(Any one fire) 1 $ 300,000
__ J CLAIMS MADE [ X I OCCUR MED EXP(Anyone person)._1$ 5, 000
A X $250 PD Ded PERSONAL BADV INJURY 2 $ 1,000,000
__- __ GENERAL AGGREGATE $ 2,0 0 0 0 0 0
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OP AGO $ 2,000, 000
PRO-
POLICY L 128,: LOC _ __-
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
(Ea accieenp $ 1, 000,000
A X ANY AUTO DT-810-161E8703-TIL-99 07/28/99 07/28/00
ALL OWNED AUTOS BODILY INJURY ' $
' SCHEDULED AUTOS (Per person)
X HIRED AUTOS BODILY INJURY $
X NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE
-- - - (Per accident)
GARAGE LIAEIII_ITY I AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN EA AU. $
AUTO ONLY: AGG , $
EXCESS LIABILITY EACH OCCURRENCE $ 1,000,000
A X OCCUR r] CLAIMS MADE DTSM-CUP-16118703-TIL-99 07/28/99 07/28/00 AGGREGATE $ 1,000,000
$
DEDUCTIBLE _ $ —
RETENTION $ $
WCSIAIU- I C1 -
WORKERS COMPENSATION AND I TORY LIMITSI._. ER
EMPLOYERS'LIABILITY I E.L.EACH ACCIDENT $
E.L.DISEASE-EA EMPLOYEE $
E.L.DISEASE-POLICY LIMIT $
OTHER
-
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: CONSTRUCTION OF WELD COUNTY BRIDGE WEL047.0-68.OB; CERTIFICATE HOLDER IS
NAMED AS ADDITIONAL INSURED AS RESPECTS THE GENERAL LIABILITY
CERTIFICATE HOLDER Y ADDITIONAL INSURED;INSURER LETTER: A CANCELLATION
BDWELDC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEE ORE THE
EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR 10 0 MAIL
BOARD OF WELD COUNTY 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
COMMISSIONERS LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OF:LIABII.I rY OF
915 10TH STREET
GREELEY CO 80631 _ANY KIND UPON -' INSURER.I AGENTS OR REPRESENTATIVES1-1 _
(fewf it ' ..,fin . (k -.7,P-JftCD Jeff Broyles • K. �'0DI _
ACORD 25-S(7/972)
2000-1582
Bond No. 8506869
PERFORMANCE BOND
KNOW ALL MEN BY THESE PRESENTS: That
Mountain Constructors, Inc.
(Name of Contractor)
P.O. Box 405, Platteville, CO 80651
(Address of Contractor)
a Corporation , hereinafter called Principal,
Corporation,Partnership,or Individual
and Fidelity and Deposit Company of Maryland
(Name of Surety)
5445 DTC Parkway, Suite 1200, Englewood, CO 80111
(Address of Surety)
hereinafter called "Surety", are held and firmly bound unto THE BOARD OF WELD COUNTY COMMISSIONERS, 915 - 10th Street,
Greeley,Colorado 80632 hereinafter called"County", in the penal sum of
Two HundredNinety Nine Thousand Nine Hundred Eighty Six and 60/100 Dollars
($ 299,986.60 ) in lawful money of the United States,for the payment of which sum well and truly to be made, we bind
ourselves, successors, and assigns,jointly and severally,firmly by these presents.
'FILE CONDITION OF THIS OBLIGATION is such that whereas, the Principal entered into a certain contract with the County, dated the
27th day of March , 2000 , a copy of which is attached and made a part hereof for the construction of:
WELD COUNTY BRIDGE WEL047.0-068.OB
NOW, THEREFORE, if the Principal shall well, truly and faithfully perform it's duties, all the undertaking, covenants, terms,
conditions, and agreements of said Contract during the original term thereof,and any extensions thereof which may be granted by the County,
with or without notice to the Surety and during the one-year (1) guarantee period, and if he shall satisfy all claims and demands incurred
under such Contract, and shall fully indemnify and save harmless the County from all costs and damages which it may suffer by reason of
failure to do so, and shall reimburse and repay the County all outlay and expense which the County may incur in making good any default,
then this obligation shall be void; otherwise to remain in full force and effect.
PROVIDED, FURTHER, that the said Surety, for value received hereby stipulates and agrees that no change, extension of time,
alteration or addition to the terms of the Contract or to work to be performed thereunder or the specifications accompanying the same shall in
any way affect its obligation on this bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the
terms of the Contract of the work or to the specifications.
PROVIDED, FURTHER, that no final settlement between the County and the contractor shall abridge the right of any beneficiary
hereunder, whose claim may be unsatisfied.
S-3172/GEEF11/97 Page 1 of 2
Bond No. 8506869
IN WITNESS WHEREOF, this instrument is executed in (number)counterparts, each one of which
shall be deemed an original,this 1st day of June , 2000 .
ATTEST:
Mountain Constructors, Inc.
Principal
v0 Pn ipa Secrets
Secretary By
(5)
(SE )
L1( L COL rcy
n as as to Principal
P.O. Box 405, Platteville, CO 80651
Address
P.O_ . Box 405, Platteville, CO 80651
Address
ATTEST:
RuelAelealtA- Fidelity and Deposit Company of Maryland
rety Secretary Surety
Renee Stein
(SEAL)
---- ee- I P BY l ,r�,'t/ ' .I.' (, Y.,
dasrely I Attome)¢ -Fact
Kathryn Y. Broyles) ���UUU JJJ
2900 S. College Avenue, #2A 5445 DTC Parkway, Suite 1200
Address Address
Fort Collins, CO 80525 Englewood, CO 80111
NOTE: Date of bond must not be prior to date of Contract. If contractor is a partnership,all partners should execute bond.
IMPORTANT: Surety companies executing bonds must appear on the Treasury Department's most current list(Circular 570 as amended)
and be authorized to transact business in the state where the project is located.
S-3172/GEEF11/97 Page 2 of 2
Bond No. 8506869
PAYMENT BOND
KNOW ALL MEN BY THESE PRESEN'T'S: That
Mountain Constructors, Inc.
Name of Contractor
P.O. Box 405, Platteville, CO 80651
Address of Contractor
a Corporation ,hereinafter called Principal, and
Corporation, Partnership or Individual
Fidelity and Deposit Company of Maryland
Name of Surety
5445 DTC Parkway, Suite 1200, Englewood, CO 80111
Address of Surety
hereinafter called "Surety", are held and firmly bound unto THE BOARD OF WELD COUNTY COMMISSIONERS. 915 - 10th Street,
P. O.Box 758, Greeley,Colorado 80632,hereinafter called"County",in the penal sum of
Two HundredNinety Nine Thousand Nine Hundred Eighty Six and 60/100 - - Dollars
($ 299,986.60 )in lawful money of the United States, for the payment of which sum well and truly to he made, we bind
ourselves, successors,and assigns,jointly and severally, firmly by these presents.
THE CONDITION Of THIS OBLIGATION is such that whereas, the Principal entered into a certain contract with the County,
dated the 27th day of March , 2000 , a copy of which is hereto attached and made a part hereof for
the construction of: WELD COUNTY BRIDGE WEL047.0-068.0B
NOW, THEREFORE, if the Principal shall, during the entire length of said Contract and any extension thereof promptly
make payment to all persons, firms, subcontractors, and corporations furnishing materials for or performing labor in the prosecution of the
work provided for in such Contract, and any authorized extension or modification thereof, including all amounts due for materials, lubricants,
oil, gasoline, coal and coke, repairs on machinery, equipment and tools, consumed or used in connection with the construction of such work,
and all insurance premiums on said work, and for all labor,performed on such work whether subcontracted or otherwise, then this obligation
shall be void; otherwise to remain full force and effect.
PROVIDED, FURTHER, that the said Surety, for value received hereby stipulates and agrees that no change, extension of
time, alteration or addition to the terms of the Contract or to the work to be performed thereunder or the specifications accompanying the
same shall in any way affect its obligation on time, alteration or addition to the terms of the Contract or to the work or to the specifications.
PROVIDED, FURTHER, that a final settlement between the County and the contractor shall abridge the right of any
beneficiary hereunder,whose claim may be unsatisfied.
531711GEEF 11/97 Page 1 of 2
Bond No. 8506869
IN WITNESS WHEREOF,this instrument is executed in (number) counterparts. each one of which
shall be deemed an original,this 1st day of June , 2000 .
Mountain Constructors, Inc.
Principal
ATTEST: �BY: ( /e /d (S)
C li 1,{n lJI tl(V
Pd ' a e Lary
(SEAL)C.)
CI
n __ P.O. Box 405, Platteville, CO 80651
Witness to Prin al Address
Fidelity and Deposit Company of Maryland
Renee Stein Surety
ATTEST:
•
Witness as to Surety Attorney-in ct
Kathryn Y. Broyle
2900 S. College Avenue, #2A 5445 DTC Parkway, Suite 1200
Address Address
Fort Collins, CO 80525 Englewood, CO 80111
NOTE: Date of bond must not be prior to date of Contract. If contractor is a partnership,all partners should execute bond.
IMPORTANT: Surety companies executing bonds must appear on the Treasury Department's most current list (Circular 570 as
amended) and be authorized to transact business in the state where the project is located.
S-3171/GEEF 11/r Page 2 of 2
Power of Attorney
FIDELITY AND DEPOSIT COMPANY OF MARYLAND
HOME OFFICE: P.O. BOX 1227, BALTIMORE, MD 21203-1227
Know ALL MEN BY THESE PRESENTS: That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, a
corporation of the State of Maryland, by F. L. BORLEIS, Vice-President, and T. C. JOHNSON, Assistant Secretary. in
pursuance of authority granted by Article VI, Section 2, of the By-Laws said Company, which are set forth on the
reverse side hereof and are hereby certified to be in full and eff the date hereof, does hereby nominate,
constitute and appoint Jeffrey L. Broyles, Michael D. , Rae L pbell, Kathryn Y. Broyles, Lawrence E.
Lutgen,Mary M.Powell,Renee Stein,Laurie A.W and Da .Meyer,all of Greeley,Colorado,EACH its
true and lawful agent and Attorney-in-Fact, to make te, seal liver, for, and on its behalf as surety, and as its
act and deed:any and all bonds and undertakin a exec f such bonds or undertakings in pursuance of these
presents, shall be as binding upon said Compan Ily and , to all intents and purposes, as if they had been duly
executed and acknowledged by the regularly a officers a Company at its office in Baltimore, Md., in their own
proper persons. This power of attorney rev.3tihat issue,�;behalf of Don. R. Broyles, Kathryn K. Coulson, Jeffrey L.
Broyles, Kevin W. McMahon, Michael a ce, Rae jr\2$fipbell, Kathryn Y. Broyles, Lawrence E. Lutgen, and Mary
M. Powell, dated June 3, 1998.
The said Assistant Secretary doe by certi the extract set forth on the reverse side hereof is a true copy of
Article VI, Section 2, of the By-L said Co p y,and is now in force.
IN WITNESS WHEREOF,the sid Vice- ent and Assistant Secretary have hereunto subscribed their names and
affixed the Corporate Seal of the said FIDE AND DEPOSIT COMPANY OF MARYLAND,this 14th day of April,
A.D.2000.
�O
O
ATTEST: FIDELITY AND DEPOSIT COMPANY OF MARYLAND tz,
C
�/ l. . Z By: Ohe L 1�11LElu 5 jj��
11L
T. C. Johns Assistant Secretary F. L. Borleis Vice-President
State of Maryland ss:
County Of Harford
On this 14th day of April, A.D. 2000, before the subscriber, a Notary Public of the State of Maryland, duly
commissioned and qualified, came F. L. BORLEIS, Vice-President and T. C. JOHNSON, Assistant Secretary of the
FIDELITY AND DEPOSIT COMPANY OF MARYLAND, to me personally known to be the individuals and officers
described in and who executed the preceding instrument, and they each acknowledged the execution of the same, and
being by me duly sworn, severally and each for himself deposeth and saith,that they are the said officers of the Company
aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal of said Company, and that the said
Corporate Seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the
authority and direction of the said Corporation.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above
written.
U
Patricia A. Trombetti Notary Public
My Commission Expires: October 9,2002
L1428-020-5343
EXTRACT FROM BY-LAWS OF FIDELITY AND DEPOSIT COMPANY OF MARYLAND
"Article VI, Section 2. The Chairman of the Board, or the President, or any Executive Vice-President, or any of the
Senior Vice-Presidents or Vice-Presidents specially authorized so to do by the Board of Directors or by the Executive
Committee, shall have power, by and with the concurrence of the Secretary or any one of the Assistant Secretaries, to
appoint Resident Vice-Presidents, Assistant Vice-Presidents and Attorneys-in-Fact as the business of the Company may
require, or to authorize any person or persons to execute on behalf of the Company any bonds, undertaking,
recognizances, stipulations, policies, contracts, agreements, deeds, and releases and assignments of judgements, decrees.
mortgages and instruments in the nature of mortgages,...and to affix the seal of the Company thereto."
CERTIFICATE
I, the undersigned, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby
certify that the original Power of Attorney of which the foregoing is a full,true and correct copy, is in full force and effect
on the date of this certificate;and I do further certify that the Vice-President who executed the said Power of Attorney was
one of the additional Vice-Presidents specially authorized by the Board of Directors to appoint any Attorney-in-Fact as
provided in Article VI, Section 2,of the By-Laws of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND.
This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution
of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and
held on the 10th day of May, 1990.
RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically
reproduced signature of any Vice-President, Secretary, or Assistant Secretary of the Company, whether made heretofore
or hereafter,wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and
binding upon the Company with the same force and effect as though manually affixed."
IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seal of the said
Company,this
1st day of June 2000
Assistant Secretary
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