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Home My WebLink About982463.tiff ACORD CERTIFICATE OF LIABILITY INSURANCE4*R DATE(MM/DD" _.. =Sal. 11/10/98 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Thomas J. Sisk & Company, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 1675 Broadway Suite 1630 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Denver CO 80202 COMPANIES AFFORDING COVERAGE John (Jay) M. Piercy IV COMPANY Phone No. 303-629-7923 Fes No. 303-892-1031 A Colorado Compensation Insuranc INSURED COMPANY B Les Matson Construction Inc. COMPANY Les Matson C P.O. Box 1830 COMPANY Greeley CO 80632 D COVERAGES THIS IS TO CERTIFY THAT THE POUCIES 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. TR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MM/DD/TY) DATE(MM/DDNY) GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ CLAIMS MADE OCCUR PERSONAL&ADV INJURY $ OWNER'S&CONTRACTORS PROT EACH OCCURRENCE $ FIRE DAMAGE(Any one fire) $ MED EXP(Any one person) $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ WC STATU- OTH WORKERS COMPENSATION AND TORY LIMITS I X ER EMPLOYERS LIABILITY EL EACH ACCIDENT S 500,000 A PARTNEPRIETOR/ X INCL 1583330 04/01/98 04/01/99 EL DISEASE-POUCYLIMIT $ 500,000 OFFICERSIEXECUTIVE EL DISEASE-EA EMPLOYEE S 500 000 OFFICERS ARE: EXCL , OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS Pax #1-970-352-2868 CERTIFICATE HOLDER CANCELLATION WELDC01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. Weld County Public Works BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Attn: Jim Brewer P.O. Box 758 OF ANY KIND UPON THE COMPANY,ITS AGENT R REPRESENTATIVES. Greeley, CO 80632 AUTHORIZED REPRESENTATIVE John (Jay) M. Piercy IV'/ 982463 ACOR➢25-S(1195) ilL :IfLi<}B,lSt �1 A /-7347/61511 age-nd& 0 ' • ACORD :•.•••,•�.pp::.:...: : DATE(MMIDDIYY) :.................................:..:..........................:.......:....:.....:....:....:..:.....:..,.;..,.,..�,A$IQkc�;...:.. 11/05/98 ::: PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Linden/Bartels & Noe Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 3459 W 20th Street Suite 114 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Greeley CO 80631 COMPANIES AFFORDING COVERAGE COMPANY Phone No. 970-356-1133 Fax No. 970-356-4088 A Bituminous Insurance Co INSURED COMPANY B Lea Matson Construction, Inc. COMPANY and A-Z Leasing C P. O. Box 1830 COMPANY Greeley Co 80632 D 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. co TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MM/DO/YY) DATE(MMIDDA'Y) GENERAL LIABILITY GENERAL AGGREGATE $2,000,000 A X COMMERCIAL GENERAL LIABILITY CLP2304092 04/01/98 04/01/99 PRODUCTS•COMP/OPAGG $2,000,000 .,. I CLAIMS MADE X OCCUR PERSONAL&ADVINJURY $ 1,000,000 OWNER'S&CONTRACTORS PROT EACH OCCURRENCE 61,000,000 FIRE DAMAGE(Any one lire) 6100,000 MEDEXP(Any one person) 65,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 A X ANY AUTO CAP2540660 04/01/98 04/01/99 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Par penal) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (PerecdMndent)O PROPERTY DAMAGE S GARAGE LIABILITY AUTO ONLY•EA ACCIDENT S ANY AUTO N/A OTHER THAN AUTO ONLY; EACH ACCIDENT 6 AGGREGATE S EXCESS LIABILITY EACH OCCURRENCE 6 1,000,000 A X UMBRELLA FORM COP2522679 04/01/98 04/01/99 AGGREGATE 61,000,000 OTHER THAN UMBRELLA FORM TTUU. 6 WORKERS COMPENSATION AND I OT RSS77VLIMITS I PR- EMPLOYERS'LIABILITY EL EACH ACCIDENT 6 THE PROPRIETOR/ INCL N/A EL DISEASE•POLICY LIMIT S PARTNERS/EXECUTIVE OFFICERS ARE: EXCL EL DISEASE•EA EMPLOYEE S OTHER A RIGGING CLP2304092 04/01/98 04/01/99 $500,000 LIMIT FLOATER $1,000 DID DESCRIPTION OF OPERATIONS&OCATIONSNEHICLE&SPECIAL ITEMS REI REHABILITATION OF BRIDGE ABUTMENTS. CERTIFiCAT.E:ItIOLDER::: ::::CANCELLAT.ION:.:.:.:.: .::::::::::::::: .:::.:::::::::::::::::.:::::::: WCBOAR1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Board of Weld County 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Commissioners/Purchasing Dept BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 915 10th Street Room 200 Greeley CO 80632 OF ANY KIN PON THE COMPANY,ITS AGENTS 0 ENTATWES. AU ENTATNE /�/j .�7 i kng"d-a 9270147/103 BOND NO. 0501167 KNOW Al,!, MEN BY THESE PRESENTS: That Les Matson Construction , Inc . Hue of Contractor PO Box 1830, Greeley. .£9 80632 Address of Contractor • Corporation , hereinafter called Principal, and Corporation, Partnership, or Individual Old Republic Surety Company Name of Surety PO Box 1976 , Des Moines , IA 50306 Address of Surety hereinafter called Surety, are held and firmly bound unto THE BOARD OF VELD COMITY COMMISSIONERS, 915 10th Street, Greeley, Colorado 80632, hereinafter called County, in the penal sum of Two Hundred Seventy—One Thousand, Two Hundred Eighty and No/100 Dollars is 271 , 280.00** % in lawful money of the United States, for the payment of which sateen and truly to be made, we bind ourselves, successors, and assigns, jointly and fly, 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 day of 1998, a copy of which is attached and made a part hereo for the construction of: prNABTLITATICM OF BRIDGE ABUTMENTS NOW, THEREFORE, if the Principal shall well, truly and faithfully perform its 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 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. t) 9Cray63 PROVIDED, t'VRTMSR, that the said Surety, for value received hereby stipulates and. agrees that no charge, extension of time( alteration or addition to the terms of the contract or to work to be performed thereunder of the specificatios acoospanying the same shall in any ways affect its obligation on this bard, 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. PRONIDCD, ELRTM6R, that no final settlement between the County and the contractor.' . shall abridge the right of any beneficiary herdunder, whose claim may' . unsatisfied. IM WITNESS McUTOF, this instrument is executed in day of , 19 . ATTEST) Les Matson Construction, Inc. 1�y� �� at— Psitpl Metre ary e • (ss es son, res en PO Box 1830, Greeley, CO 80632 witness as to Principal Address Address ' ATTEST: cretary Debra r Old Republic Surety,CQmpan y pi • By nos as to furety Attorney i Fact -( '6i h• Powell ,curie 'Wadding PO Box 1976 31159 8 20th Street, Suite 114 Address Address Oiecl.el, CO 80631 Des Moines , IA 50306 Mott: 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 moat current list (circular S70 as amended) and be authorized to transact business in the state where the project is located. 18 qg;v&3 BOND NO. 0501167 111419222.S@ • • SNOW ALL NEN BY THESE PRESENTS: That Les Matson Construction , Inc. Name of Contractor • PO Box 1830, Greeley, CO 80632 Address of Contractor • Corporation , hereinafter called Principal, and Corporation, Partnership pr Individual . • Old Republic Surety Company Name of surety of , 19 , a copy of which is hereto attached and made a part hereof for the construeETon of: BENARII.ITATION OF FRIDGE ASUTENTS NOW, THEREIOSE, if the Principal shall during the entire length of said contract and any extension thereof pra.ptly make payment to all persdns, firms, subcontractors, and corporation furnishing materials for or performing labor in the prosecution of the work provided for in such contract, and any authorised 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 in such work whether subcontractor 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 acco.psnying the same shall in any way affect its obligation on tine, 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. 19 9:24/&-3 • • IN WITNESS WHEREOF, this instrument is executed in three (3) (number) • ooantetparts, each one of which shall be deemed en original, this the day of , I! • • wrest I, oo struption, Inc. BY ��..yy.� 333eeeccc _ - Pirtw paf ntary PO Box • 1830 1SG1:) Address Greeley, CO 80632 Il1tness as to Principal • Address MIST: Secretary Debr Old Republic SuregyCany� (Sit RY � i.au r �ide& oSurety Atto • - n-fact Mary N. Powell 3454 .W 20th Street , S to 114 PO Box 1976 Address Address Greeley, CO 80631 Des Moines , IA 50306 MOTE: 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. • 20 �` = r - _ ==C. - -'---=- POWEPPIDEATTORIat- 71- KRt33W ALtiviEN:t Z PR ' -- -Ttt -�iLOREP_UBL-fC$k!€3ETY 2MPAf]YC a econal tcunsvrra#ncaa€arm _ s makercor f#trte-arid ppr nt< =- -- = _ - L(*FENCE-; 1-UT tJ JEFt 4_t FI tS�_ `tAV I- tat i€-#ERA MARY: t t tDWEL • ats#Lue and lawful Merrta (3j#n et wath=fafft der andautl wxst fot anrt onbeha oRhe oofripsnpas surer to�twecuteattd de vvar andattaK-tni sestetthe eontianyihereto(ita�r6Sgrt ttftondan4(gr ritrreeQ9nr�nca�oroihi�vf#termsf $tiofasinthertatairetttereot fl rbdifbat tItlazes hatTd, t- - jfiEtstt botat mod s att n Iussanteks701- dalmsnt. 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