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HomeMy WebLinkAbout168787 GOLDEN TRIANGLE CONSTRUCTION INC - INSURANCE CERTIFICATErilant - RRRI; r-nl nTol ACORUM CERTIFICATE OF LIABILITY INSURANCE 10f02f06°"YY"' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HRH of Colorado ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 720 S. Colorado Blvd Ste 600-N HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 469025 Denver, CO 80246-9025 INSURERS AFFORDING COVERAGE NAIC 9 INSURED INSURERA: CNA Insurance Companies B6486 Golden Triangle Construction, Inc. 700 Weaver Park Rd. INSURER B: Pinnacol Assurance 10780 INSURERc: Fireman's Fund Insurance Company 21873 Longmont, CO 80501 INSURER D: INSURER E: COVERAGES 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 "Do N R TYPE OF INSURANCE POLICY NUMBER DATE IMMF D/YYICY E PDAT Y EXPMM 1 RAT DIYY N LIMITS A GENERAL LIABILITY TCP2022866738 12/31/05 12/31/06 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDPREMISES (Ea occunrence) $SOO OOO CLAIMS MADE � OCCUR MED EXP (Any one person) $S 000 PERSONAL B ADV INJURY $1 000 000 GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG 0 OOOPOLICY X JECOT X LOC A AUTOMOBILE LIABILITY ANY AUTO C2022866741 12/31/05 12/31/06COMBINED SINGLE LIMIT (Ea accident) rs2,000,000 0,000X INJURY (Per person) ALL OWNED AUTOSBODILY SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIREOAUTOS NON-OWNEDAUTOS X X PROPERTY DAMAGE (Per accident) $ Physical Damage Dad. Apply X ACV GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG A EXCESSIUMBRELLA LIABILITY CUP2022866786 12/31/05 12/31/06 EACH OCCURRENCE $5000000 X OCCUR CLAIMS MADE AGGREGATE $5 000 000 $ DEDUCTIBLE $ X RETENTION $ 10 000 B WORKERS COMPENSATION AND 4013024 10101/06 10/01/07 X I WCSTATU OTH- ITS 4 TORYEMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 If yea. describe under SPECIAL PROVISIONS below I I I E.L. DISEASE - POLICY LIMIT $1,000,000 C OTHER Leased &/or MX198473515 01/01/06 01/01/07 $100,000 Rented Equipment $1,000 Ded. Owned Equipment ACV DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS ' The following cancellation conditions always apply: -10 days for non-payment of premium - If policy shown, 10 days for Workers' Compensation for fraud; material misrepresentation; non-payment of premium; other reasons approved by the Commissioner of Insurance City of Ft. Collins 215 N. Mason PO Box 580 Fort Collins, CO 80524 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL •_in DAYS WRITTEN 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 ACORD 25 (2001108) 1 of 2 fMS3n64261M302209 JXA © ACORD CORPORATION 198E IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 253 (2001108) 2 Of 2