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Home My WebLink AboutGRAYCOR CONSTRUCTION COMPANY INC - INSURANCE CERTIFICATE 2023-2024CERTIFICATE OF LIABILITY INSURANCE an� �MMrowrrvv� 'fHIS CERTIFICAT� IS ISSUEp AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS kJPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIYELY OR N�GATIVELY A14l�N�, EXTfND OR ALTER TFfE CpVERAGE AFFORDE� BY TIiE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSl11NG INSURER{S), AUTHORtZE� REPRESENTATIVE OR PRODUCER, ANb 7H� CERTIFICATE HOLDER. iMPORTANT: If the certiflcate holder Is an ADDITIONAL INSUItED, the policy�ias) must have ADDITIONAI. iNSURED provisiona or be endorsad. If SUBROGATION 15 WAiVEd, subject to the tarms and conditions of the poEicy, cerlain palicies may raquire an endorsement A statement on thls certiflcate does not confer riahts to the certiilcate holder in Ileu of suah endorsementfsl. PRODUCER AC1G Insurance Agency, Inc. 260Q N. Centra! Ex wy. Suite 800 Richardson, TX 75�80 INSliREO Graycor Construction Company Inc. Two Mid America Plaza, Suite 400 Oakbrook Terrace IL 60181 205D8 COVERAGES CER7IFICATE NUMBER: 74391644 REVISION NUMBER: THIS IS i0 CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN iSSUED TO THE ENSURE� NAMED ABOVE FOR THE POLICY PERIOD INDICAT�D NOTIMTHSTANDING ANY REQUIREMENT, TERM OR COIVDITION OF ANY CONTRACT OR OTHER DOCUMENT VMTFi RESPECT TO 1NHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, TNE INSURANCE AFFdRDED BY THE POLICIES DESCRIBE� FiEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSkpNS AND CON�ITIOMS OF StICH POLICIES. LIMITS SHQWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ��7R iYPE OF INSURANCE � pOLICY NIIMBER �uCY EFF MOLICY El(P LJMIiS A �/ COMMERCIALGENERALLIABILITY GL23A00016 6�1�2a23 �ii2��4 EqCHOCCURRENCE S10U00000 A CLAIM&MADE � oCCua GL23BD0016 (GI. �XCess) 6/1I2U23 6/112024 PREMI E Ea «ence S 1 OO OOO A GL23C04016 (GL ExCeSS� 611I2423 6/112024 ME� EJ(P (Any one person) E 5 040 PERSONAL b ADY INJl1RY S'I O OQO OOO GEN'L AGGREGATE LIAAIT APPLIES PER: GENERAL AGGREGATE S 1 O,OOO,OOO POLICY ✓� �E o- � LOC PRODUCTS - COMPfOP RGG f 1 O OOO OOO OTHER: s C nuroµoei�unewrr 7033770231 6/1/2023 611I2024 ��IdeDtSINGLE LIMIT s5 U4U 000 � ANY AU7O BODILY INJURY (Per person] i OWNEQ SCHEOULED BODILY INJURY (Per ecudent� S AUTOS ONLY AUTOS HIREb NON-0WNED pROPERTY pAMAGE E AUTOS ONLY AUTOS ONLY Per accidanl a UMBRELLALlpB p�UR EACHOCCl1RRENCE 5 EXCESS LIAB CLAIMS-MADE AGGREGA7� S DED RETENTION S B WORKERSCOIYIPENSATION WCA00001Q023 611I2023 6�'��2024 �/ �AT TE ERH AND EMPLOYERS' LIABILIiY B Y! N WCAOOQ005923 611I2023 6/1/2024 g � CEWMEM ERRF�(C UD p7�C�ryE � N!A w�caaoao�322s 611l2023 sj�J2Q24 E.LEACHACCI�ENF Si ��0� (Mandatory In NH} E.L. OISEA5E- EA EMFLOYEE S If yes, describe under OESCRIPTfON OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S'I OOO OOO OESCRIPiION OF OPERATIONS 1 LOCATIONS! VEHICLES �ACORD 101, Addidortal Remarka SeMdule, may be tllseMd iF more space i� requirad� Re: Contrador Lice�se —See Attached Remarks Scheduie-- Contrattor License City Of Fort Collins P.CS Box 580 330 5. College A�e. Fort Collins CO 80522-Q580 ACORD 25 (2016l03) $HOUI.D ANY OF THE ABOVE �ESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION �ATE THEREOF, NOTICE WfLL BE DELIVERED IN AGCORDANCE WITH THE POLICY PROVISIONS. AUiHORIZEDREPRESENTAl1VE A T� R �/"� Brian Callaahan � 1988-2015 ACORD COltPORATION. All rights reserved. The ACORD name and logo are registared marks of ACORD 79391649 I GAAYCOR I z3l24 GL AL WC I AbCie Fiahex I 5/15/2023 3:19:50 PM fCST) I pdge � of 2 This certificate canceis and supersedes ALL previously issued certificates. AGEHCY CUSTOMER ID: GRAYCdR LOC #: ACORO� �� AGENCY AGIG Insurance A en , roucv NUMe� CARRIHR ADDITIONAL REMARKS ADDITlONAL REMARKS SCHEDULE NAIC C06E THIS AOOITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Cerllficate of Liahility {03116} HOLDER: City Ot Fort Collins ADDRESS: P.O. Box 580 330 S. College Ave. FoR Collins CO 80522-0580 NAMFA INSUREO Graycor Construction Company Inc. OHkbr�odokT rra�cePL fidlgi�e400 EFFECTIVE DATE: Page oi AL - If these policies are cancei�ed, non--renewed or materially chanqed, 60 days notice, except �0 days for nvnpayment of preinium, will be mailed to the certificate holders where written nota.ce of cancel_ation, nnnrenewal nr material change to this policy is required by writ�en contract, permit ar agreement wish ihe Named Insured. GL - If these p;�iicies are cancelled, naR-renewed or materially changed, b0 days notice, except iQ days fox nonpayment of premium, wi=�� be mailed to the Certificate Holder, when required by wr�tY.en contract, permit or agreement with the Named Insured. WC - I� these policies are cancelled, non-renew�d c�r ma�erially changed, 50 days notice, except 10 days for nonpayment of premium, will be mailed to the Certificate Holder, when required by written contract, pez'rni� or agreemen= with the Named Insured. ACORD 101 (20081p7) � 2008 ACORD CORPORATION. A!1 rights reserved. Tha ACORD name and logo are registered marks of ACORD ADDENdUMlD00 74391649 I GRAYCOR i 23/2q GL AL NC AbGie Fisher I 5/15l2023 3:14:50 PH iCST) I Page 2 of 2 This certificate cancels and supersedes ALL previously issued cer[ificates.