HomeMy WebLinkAboutKTK General Contracting Limited - Insurance Certificate AC RD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNYYY)F12/2312024
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 .
CRS Insurance Brokerage NAMTACT
E: Ginny Kipling
PHONE
9780 S Meridian Blvd Suite 400 , 303-996-7800 ac No):303 757 7719
Englewood CO 80112 E-MAIL
ADD Ess: gkipiing@crsdenver.com
INSURER S AFFORDING COVERAGE NAIC Y
INSURER A: Pinnacol Assurance 41190
INSURED KTKGENE-01 INSURER B: Employers Mutual Casualty Go 21415 KTK General Contracting Limited
KTK General Contracting Limited LLC INSURERC: Illinois Union Insurance Company
KTK General Contracting Corporation INSURERD: Hiscox Insurance Company 10200
3755 W. 69th Place ----- ----- - -- - -------
Westminster CO 80030 INSURER E:
INSURER F
COVERAGES CERTIFICATE NUMBER:1645378026 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 _ _.. -_iADDL`SUBRI.
LTR TYPE OF INSURANCE 'IN D'WVD 1 POLICY NUMBER MM/DD YYYY fdM/LDi D YYYY LIMITS
B X COMMERCIAL GENERAL LIABILITY 6X28117 1/1/2025 1/1/2026 EACH OCCURRENCE $1,000.000
CLAIMS-MADE X OCCUR rPRgI SE_S E4 occurrpng9l $500,000
j MED EXP(Any one person) $10,000
PERSONAL 8 ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE E $2,000,000
POLICY,!
X I O - LOC ------- --
LJ j PRODUCTS-COMP/OPAGG $2,000,000
OTHER:
$
B ----1 AUTOMOBILE LIABILITY BX28117 1/1l2025 1 1/1/2026 COMBINED SINGLE LIMIT $1,000,000
X ANY AUTO (Ea accidenij.— ___
BODILY INJURY(Per person) $
OWNED F—,SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY(Per accident) $
X ! HIRED X NON-OWNED PROPERTYDAMAGE $
AUTOS ONLY
B X UMBRELLA LIAB IPer-a_ccidentJ
. AUTOS ONLY
$
X i OCCUR 6X28117 1/1/2025 i 1/1/2026 EACH OCCURRENCE $7,000,000
EXCESS LIAB CLAIMS MADE AGGREGATE 7,000,000
� __ $
i DED I X ; RETENTIONS � $
A WORKERS COMPENSATION 14136407 1/1/2025 1/1/2026 X 1 PER OTH-
AND EMPLOYERS'LIABILITY Y/N !STATUTE , ER
ANYPROPRIETORiPARTNER/EXECUTIVE
OFFICER/M EMBER EXCLUDED? a j N/A'
E.L EACH ACCIDENT $1,000,000
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
j If yes,describe under _
DESCRIPTION OF OPERATIONS below Pollution LiabilityatLiability6X28 E.L.DISEASE-POLICY LIMIT $1,000,000
C
e Leased/Rented Equipment 117 1l112025 1!1l2026 UmR/Ded 250,000/1,000
D !Professional Liability G24394554012 j 5/9/2024 5l9/2025 Lim4 2,000,000
ANE5443878 6/10/2024 6/10/2025 !Limit 1.000,000
I
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS.
281 N. College
Fort Collins CO 80526 AUTHORIZED REPRESENTATIVE
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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