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Home My WebLink AboutBVB General Contractors, LLC - Insurance Certificate 2023 DATE(MM/DD/YYYY) ACORO® CERTIFICATE OF LIABILITY INSURANCE 10/10/2023 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 CONTACT Moody Insurance Agency NAME: Moody Insurance Agency,Inc. (A/M. PH A/jcNr o Exc): (303)824-6600 F� No): (303)370-0118 8055 East Tufts Avenue EMAIL certrequest@moodyins.com ADDRESS: Suite 1000 INSURER(S)AFFORDING COVERAGE NAIC# Denver CO 80237 INSURERA: Charter Oak Fire Insurance Co 25615 INSURED INSURER B: Travelers Property Casualty Co ofAmerica 25674 BVB General Contractors,LLC INSURER C: Pinnacol Assurance 41190 1289 S 4th Ave INSURER D: Travelers Indemnity Co ofAmerica 25666 INSURER E: Brighton CO 80601 INSURER F: COVERAGES CERTIFICATE NUMBER: 23-24 Master 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 TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE FX_I OCCUR PREMISES Ea occurrence) $ 300,000 MED EXP(Any one person) $ 10,000 A DTC06D818429COF23 10/10/2023 10/10/2024 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑X PRO 2,000,000 JECT LOC PRODUCTS $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANYAUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED BA6N6989692326G 10/10/2023 10/10/2024 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Underinsured motorist BI $ Included UMBRELLA LIAB "'y'V"""' 5,000,000 OCCUR EACH OCCURRENCE $ B EXCESS LIAB CLAIMS-MADE CUP9J1545362326 10/10/2023 10/10/2024 AGGREGATE $ 5,000,000 X DED I I RETENTION$ 10,000 $ WORKERS COMPENSATION /� STATUTE EORH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 C OFFICER/MEMBER EXCLUDED? NIA 4059097 10/01/2023 10/01/2024 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S Contractors Equipment Scheduled Equipment $235,128 D QT6609C600820TIA23 10/10/2023 10/10/2024 Deductible $1,000 DESCRIPTION OF OPERATIONS/LOCATIONS I 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 North College Avenue PO BOX 580 AUTHORIZED REPRESENTATIVE Fort Collins CO 80522 ljow 1/ vmnvayws—4plp Cv f @ 1988988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 00012232 LOC#: ,aCC>RV ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED Moody Insurance Agency,Inc. BVB General Contractors,LLC POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance:Notes CONTRACTUAL LIABILITY APPLIES PER POLICY TERMS AND CONDITIONS Leased/Rented Equipment—Travelers Indemnity of America,NAIC 25666,Policy number QT6609C600820TIA23,$250,000 limit,$1,000 deductible Installation Floater—Travelers Indemnity of America,NAIC 25666,Policy number QT6609C600820TIA23,$2,000,0000 limit,$1,000 deductible General Liability: CG D2 46 04 19 Form Attached Includes: Blanket Additional Insured(Contractors)with Ongoing and Completed Operations and Primary and Non-Contributing wording status applies only to the extent provided in form CG D2 46 04 19 when required by written contract. CG D3 16 02 19 Form Attached Includes: Blanket Additional Insured status applies only to the extent provided in form CG D3 16 02 19 when required by written contract. Blanket Waiver of Subrogation applies only to the extent provided in form CG D3 16 02 19 when required by written contract. IL T4 05 05 19 Form Attached Includes: Blanket 30 days'Notice of Cancellation applies only to extent provided in form IL T4 05 05 19 when required by written contract. CG D2 11 01 04 Form Attached Includes: Designated Project General Aggregate applies only to the extent provided in form CG D2 11 01 04 when required by written contract. Auto Liability: CA T3 53 02 15 Form Attached Includes: Blanket Additional Insured status applies only to the extent provided in form CA T3 53 02 15 when required by written contract. Blanket Waiver of Subrogation applies only to the extent provided in form CA T3 53 02 15 when required by written contract. Umbrella Liability: Umbrella Liability policy is on a follow form basis for the following underlying insurance coverages:General Liability,Automobile Liability,and Employers Liability. Worker's Compensation: 359-B form Attached Includes Blanket Waiver of Subrogation.Status applies when required by written contract. IMPORTANT: The policy forms referenced will be sent via email only.To obtain copies,please send your request with the email address to certrequest@moodyins.com ACORD 101 (2008/01) @ 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD