HomeMy WebLinkAbout113752 BT CONSTRUCTION - INSURANCE CERTIFICATEACORD. CERTIFICATE OF LIABILITY INSURANCE 10/01/2007 09/26/200 '
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Lockton Companies ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
8110 E Union Avenue HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Suite 700 ALTER THE COVERAGE AFFORDED CTDenver CO 80237
(303) 414-6000 INSURERS AFFORDING COVERAGE
INSURED INSURER A: Travelers Pr . Casualty
1047338 BT Construction, Inc.
Attn: Michelle Ciancio INSURER B : Pinnacol Assurance
9885 Emporia Street INSURER C
Henderson, CO 80640
rnvan wn_ec M�f'nXTnt N rT T THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE IMNU DfYY1
POLICY EXPIRATION
DATE (MMtDDfYYI
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE Fx—I OCCUR
DTCO0605C7181ND06
10/03/2006
10/03/2007
EACH OCCURRENCE
1,000,000
FIRE DAMAGE (Any one fire
$ 300,000
MED EXP (Any oneperson)
$ 5 000
PERSONAL&ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE
POLICY EX]JECT
LIMIT APPLIES
X
PER:
LOC
PRODUCTS - COMP/OP AGG
$ 2,000.000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNEDAUTOS
DT8100605C718TIL06
CIT
lid 1{�7�i
�J " I sJ 2006
OF FORT COLLINS
�'J
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
X
BODILYINJURY
son)
(Perrperson)
$ XXXXXXX
X
INUX
(Per D cILY cident)
$ XXXXXXX
(Pe aPEc T DAMAGE
$ XXXXXXX
GARAGE LIABILITY
ANY AUTO
NOT APPLICABLE
AUTO ONLY - EA ACCIDENT
$ XXXXXXX
OTHER THAN EA ACC
AUTO ONLY: AGG
XXXXXXX
$ XXXXXXX
A
EXCESS LIABILITY
X OCCUR CLAIMS MADE
xUMBRELLA
DEDUCTIBLE FORM
RETENTION $
DTSMCUP0605C718TIL06
10/03/2006
10/03/2007
EACH OCCURRENCE
$ 1,000,000
AGGREGATE_
$ 1,000,000
XXXXXXX
XXXXXXX
$ XXXXXXX,
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
4023016
10/01/2006
10/01/2007
X WC STATU- DTH-
FIR
E.L. EACH ACCIDENT
$ 100,000
E.L. DISEASE - EA EMPLOYEE
$ 100,000
E.L. DISEASE- POLICY LIMIT
$ 500,000
OTHER
—F
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
RE: Project - Bobcat Ridge Trail Parking. City of Fort Collins is included as an Additional Insured with respects to General and Auto Liability.
2562398 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Fort Collins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30
300 Laporte Ave. DAYS WRITTEN
Fort Collins, CO 80522 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
I If /,/G
ACORD 25-S (7/97) For question regarding this oer ific , contaet the number listed In the Rroducsr'section above and specify the cliard cod.'BTCONOtt d) ACORD CORPORATION 1 QRR