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HomeMy WebLinkAbout166269 GARNEY CO - INSURANCE CERTIFICATE (2). Ns cemlrcate is executed by Liberty Mutual Insurance (3roup as respects such insurance as is afforded by those companies. BM0068 Certificate of Insurance This certificate is issued as a matter of information only and confers no rights upon you the certificate holder. This certificate is not an insurance policy and does not amend, extend, or alter the coverage afforded by the policies listed below. lhls is to certify that (Name and address of Insured) GARNEY CONSTRUCTION 10822 W TOLLER DRIVE, SUITE too LITTLETON, CO 80127 s, at the issue date of this certificate, insured by the Company under the policy(im) listed below. The insurance afforded by the listed po s not akere,] by flnv reooil . rent fPn,n nr rnnrtilinn of anv rnnirnrf nr n11u�e ,rnrn.rronl unlF wmnrf fn ...1,:..1. ,l.:n ..nw:f:..n,n ...... L- :-....-a Exviration Type Continuous* Extended Policy Term JX Workers Compensation . General Liability Claims Made X Occurrence Retro Date Automobile Liability X Owned X I Non -Owned X Hired FOE to all their terms, exclusions and conditions and Eff . Date(s) Policy Numbers) Limits of Liability 10/01/2006 / 10/OI/2007 WA2-14D-426942-736 Coverage afforded under WC law of Employers Liability the following states: Bodily Injury By Accident AR, AZ, CO, FL, GA, KS, KY, MO, NE, $1,000,000 Each Accident OK, SC, SD, TN, TX, UT, WY Bodily Injury By Disease $1,000,000 Policy Limit Bodily Injury By Disease $1,000,000 Each Person 10/01 /2006 / 10/01/2007 I TB2-141-426942-726 I General Aggregate -Other than Prod/Completed Operations Products/Completed Operations Aggregate Bodily Injury and Property Damage Liability Per $1,000,000 1 Occurrence Personal and Advertising Injury I Per Person / Other Liability Other Liability $300,000 Fire Legal $10,000 Medical 10/01 /2006 / 10/01/2007 AS2-141-426942-716 Each Accident - Single Limit - B. I. and P. D. Combined Each Person Each Accident or Occurrence Each Accident or Occurrence C *WA Policy includes deductible endorsement with $250,000 deductible per occurrence/claims (disease) with the provision that Liberty Mutual will (may) advance payment of O the deductible amount. -- Project: Spring Creek Pre -Disaster Mitigation C&S RR Detendon Pond. The City of Fort Collins, and Rothberg, Tamburini and Winsor are additional M insured with respect to general liability where required by written contract M E N T -it the certificate expiration date is continuous or extended term, you will be notified if coverage is terminated or reduced before the certificate expiration date. However, you will not be notified annually of the continuation of coverage. Special Notice - Ohio: Any person who, with intent to defraud or knowing that he / she is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud. Important information to Florida policyholders and certificate holders: in the event you have any questions or need information about this certificate for any reason, please contact your local sales producer, whose name and telephone number appear; in the lower left corner of this certificate. The appropriate local sales office mailing address may also be obtained by calling this number. Notice of cancellation: (not applicable unless a number of days is entered below). Before the stated expiration date the company will not cancel or reduce the insurance afforded under the above policies until at least 60 days notice of such cancellation has been mailed to: Office: OVERLAND PARK, KS Phone: 913-681-1700 Certificate Holder: City of Fort Collins 300 LaPorte Avenue Fort Collins, CO 80522 CHRISTINA GRAVELY Date Issued: 09/11/2006 Prepared By: CH !'his certificate is executed b Liberty Mutual Insurance Group as such insurance as is afforded by those companies. BMM69 Certificate of Insurance This certificate is issued as a matter of information only and confers no rights upon you the certificate holder. This certificate is not an insurance policy and does not amend, extend, or alter the coverage afforded by the policies listed below. This is to certify that (Name and address of Insured) GARNEY CONSTRUCTION 10822 W TOLLER DRIVE, SUITE 100 LITTLETON, CO 80127 is not altered by anv requirement, term or condition of anv contract or other document with respect to which this certificate may be Expiration Tvpe iXContinuous* Extended Policy Term Workers Compensation General Liability HClaims Made X Occurrence Retro Date Automobile Liability X Owned X Non -Owned X Hired to all their terms, exclusions and conditions and EffJExp. Date(s) Policy Number(s) Limits of Liability 10/01/2006 / 10/01/2007 WA2-14D426942-736 Coverage afforded under WC law of Employers Liability the following states: Bodily Injury By Accident AR, AZ, CO, FL, GA, KS, KY, MO, NE, $1,000,000 Each Accident OK, SC,SD,TN,TX,UT,WY Bodily Injury By Disease $1,000,000 Policy Limit Bodily Injury By Disease $1,000,000 Each Person 10/01/2006 / 10/01/2007 1 TB2-141-426942-726 I General Aggregate -Other than Prod/Completed Operations Products/Completed Operations Aggregate Bodily Injury and Property Damage Liability I Per Personal and Advertising Injury I Per Person / Other Liability I Other Liability $300,000 Fire Legal $10,000 Medical lO/Ol/2006 / 10/01/2007 AS2-14tA26942-716 Each Accident - Single Limit - B. I. and P. D. Combined Each Person Each Accident or Occurrence Each Accident or Occurrence C I *WA Polity includes deductible endorsement with $250,0W deductible pet occurrence/claims (disease) with the provision that Liberty Mutual will (may) advance payment of O the deductible amount. —Project: Dry Creek Drainage Improvements -East Vine Diversion Channel, Spillway & Turnout Structure. City of Fort Collins, Larimer and Weld M Irrigation Company and URS Corporation, Iuc. are additional insured with respect to general liability where required by written contract E N T S *If the certificate expiration date is continuous or extended term, you will be notified if coverage is terminated or reduced before the certificate expiration date. However, you will not be notified annually of the continuation of coverage. Special Notice - Ohio: Any person who, with intent to defraud or knowing that he / she is facilitating a fraud against an insurer, submits an application or fries a claim containing a false or deceptive statement is guilty of insurance fraud. Important information to Florida policyholders and certificate holders: in the event you have any questions or need information about this certificate for any reason, please contact your local sales producer, whose time and telephone number appears in the lower left corner of this certificate. The appropriate local sales office mailing address may also be obtained by calling this number. Notice of cancellation: (not applicable unless a number of days is entered below) . Before the stated expiration date the company will not cancel or reduce the insurance afforded under the above policies until at least 60 days notice of such cancellation has been mailed to: Office: OVERLAND PARK, KS Phone: 913-681-1700 Certificate Holder. City of Fort Collins, Colorado 300 Laporte Avenue Fort Collins, CO 80522 CHRISTINA GRAVELY Date Issued: 09/11/2006 Prepared By: CH -his certificate is executed by Liberty Mutual Insurance Group as respects such insurance m is affomded'oy those companies. BM0068 Certificate of Insurance This certificate is issued "a matter of information only and confers no rights upon you the certificate holder. This certificate is not an insurance policy and does not amend. extend, or alter the coverage afforded by the policies listed below. This is to certify that (Name and address of Insured) GARNEY CONSTRUCTION 10822 W TOLLER DRIVE, SUITE 100 LITTLETON, CO 80127 is not altered by any requirement, term or ExPiration Type Continuous* Extended Policy Tenn X Workers Compensation General Liability HClaims Made X Occurrence Retro Date Automobile Liability X Owned X Non -Owned X Hired by the Company under the policy(im) listed below. The insurance afforded by the listed policy(ies) is subject to all their terms, exclusions and conditions and edition of any contract or other document with respect to which this certificate my be issued. EffJExp, Date(s) Policy Number(s) Limits of Liability 10/01/2006 / 10/01/2007 WA2-14D-426942-736 Coverage afforded under WC law of Employers Liability the following states: Bodily Injury By Accident AR, AZ, CO, FL, GA, KS, KY, MO, NE, $1,000,000 Each Accident OK, SC, SD, IN, TX, UT, WY Bodily Injury By Disease $1,000,000 Policy Limit Bodily Injury By Disease $1,000,000 Each Person 10/01/2006 / 10/01/2007 I TB2-141-426942-726 I General Aggregate -Other than Prod/Completed Operations ProductslCompleted Operations Aggregate Bodily Injury and Property Damage Liability I Per Personal and Advertising Injury I Per Person / Other Liability Other Liability $300,000 Fire Legal $10,000 Medical 10!0V2006 / 10/01/2007 AS2-141-426942-716 Each Accident - Single Limit - B. I. and. P. D. Combined Each Person Each Accident or Occurrence Each Accident or Occurrence C I *WA Policy includes deductible endorsement with $250,000 deductible per occurrence/claims (disease) with the provision that Liberty Mutual will (may) advance payment of O the deductible amount. -- Project: Dry Creek Drainage Improvements - Irrigation Conveyance Improvements. City of Foil Collins, Colorado, Stantec, Inc. and URS Corporation, M Inc., are additional insureds as respects general liability. E N T .it me cermicate expiration date is continuous or extended term, you will be notified if coverage is terminated or reduced before the certificate expiration date. However, you will not be notified annually of the continuation of coverage. Special Notice - Ohio: Any person who, with intent to defraud or knowing that be / she is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud. Important information to Florida policyhoiders and certificate holders: in the event you have any questions or need information about this certificate for any reason, please contact your local sales producer, whose name and telephone number appears in the lower left corner of this certificate. The appropriate local sales office mailing address may also be obtained by calling this number. Notice of cancellation: (not applicable unless a number of days is entered below) . Before the stated expiration date the company will not cancel or reduce the insurance afforded under the above policies until at least 60 days notice of such cancellation has been mailed to: Office: OVERLAND PARK, KS Phone: 913-681-1700 Certificate Holder: City of Fort Collins, Colorado 300 Laporte Avenue Fort Collins, CO 80522 CHRISTINA GRAVELY Date Issued: 09/11/2006 Prepared By: CH this certificate is executed by Liberty Mutual Insurance Group as respects such insurance as is afforded by those companies. BM0068 Certificate of Insurance This certificate is issued as a matter of information only and confers no rights upon you the certificate holder. This certificate is not an insurance policy and does not amend, extend, or alter the coverage afforded by the policies listed below. This is to certify that (Name and address of Insured) GARNEY CONSTRUCTION 10822 W TOLLER DRIVE, SUITE 100 LITTLETON, CO 80127 s, at the issue date of this certificate, insured by the Company under the policy(im) listed below. The insurance afforded by the listed policy(ies) is subject u is not altered by any requirement Expiration TvDe Continuous* Extended Policy Term JX Workers Compensation General Liability HClaims Made X Occurrence Retro Date Automobile Liability X Owned X I Non -Owned X Hired 10/01/2006110/01/2007 1 WA2-14D426942-736 10101/200611010112007 1 TB2-141-426942-726 r�1 all their terms, exclusions and conditions and Limits of Coverage afforded under WC law of the following states: AR, AZ, CO, FL, GA, KS, KY, MO, NE, OK, SC, SD, TN, TX, UT, WY Employers Liability Bodily Injury By Accident $1,000,000 Each Accident Bodily Injury By Disease $1,000,000 Policy Limit Bodily Injury By Disease $1,000,000 Each Person General Aggregate -Other than Prod/Completed Operations $2,000,000 Products/Completed Operations Aggregate $2,000,000 Bodily Injury and Property Damage Liability Per $1,000,000 Occurrence Personal and Advertising Injury I Per Person / Other Liability Other Liability $300,000 Fire Legal $10,000 Medical 10/01/2006 / 10/01/2007 AS2-141426942-716 Each Accident - Single Limit - B. I. and P. D. Combined Each Person Each Accident or Occurrence Each Accident or Occurrence C *WA Policy includes deductible endorsement with $250,000 deductible per occurrence/claims (disease) with the provision that Liberty Mutual will (tray) advance payment O the deductible amount. -- Project: Dry Creek Drainage Improvements - Dry Creek SCADA System. City of Fort Collins, Latimer and Weld Irrigation Company and URS M Corporation, Inc. are additional insured with respect to general liability where required by written contract. M E N T -n the certificate expration date is continuous or extended term, you will be notified if coverage is terminated or reduced before the certificate expiration date. However, you will not be notified annually of the continuation of coverage. Special Notice - Ohio: Any person who, with intent to defraud or knowing that he / she is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud. Important information to Florida policyholders and certificate holders: in the event you have any questions or need information about this certificate for any reason, please contact your local sales producer, whose name and telephone number appears in the lower left comer of this certificate. The appropriate local sales office mailing address may also be obtained by calling this number. Notice of cancellation: (not applicable unless a number of days is entered below) . Before the stated expiration date the company will not cancel or reduce the insurance afforded under the above policies until at least 60 days notice of such cancellation has been mailed to: Office: OVERLAND PARK, KS Phone: 913-681-1700 Certificate Holder: City of Fort Collins 300 LaPorte Avenue Fort Collins, CO 80522 CHRISTINA GRAVELY Date Issued: 09/11/2006 Prepared By: CH POLICY NUMBER: HDOG23719290 COMMERICAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Persons Or Organ izations : If required by contract, CITY OF FT COLLINS Locations) Of Covered Operations 1i4090010 All as required by contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Endorsement #A2 ADDITIONAL INSURED OWNERS,- LESSEES OR CONTRACTORS -NAMED INSU 2EWS ACTS OR OMISSIONS ONLY A. Section II —Who is An Insured is amended to include as B. With respect to the insurance afforded to these additional an additional insured the person(s) or organization(s) insureds, the following additional exclusions apply: shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and This insurance does not apply to 'bodily injury" or advertising injury" caused solely by: "property damage" occurring after: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. 1. All work, including materials, parts or equipment fumished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same Endorsement #A2A Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused solely by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products - completed operations hazard."