HomeMy WebLinkAbout113752 BT CONSTRUCTION - INSURANCE CERTIFICATE (2)ACORDT. CERTIFICATE OF LIABILITY INSURANCE 10/01/2007 09/26/2006)
PRODUCER Lockton Companies THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
P 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 AFFOR ED ByDenver CO80237
(303) 414-6000 INSURERS AFFORDING COVERAGE
INSURED INSURER A: Travelers Pro . Casualty
1047338 BT Construction, Inc.
9885 Emporia Street INSURER B: Pirtnacol Assurance
Henderson, CO 80640 INSURER C
INSURER 0
......�.....�.. nm %Tnt T TT 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
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDDIYY
POLATICY EXPIRATION
DE MMfDDIYY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FRI OCCUR
DTC00605C718IND06
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 B ADV INJURY
$ 1,000,000
GENERALAGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES
POLICY X JECT X
PER:
LOC
PRODUCTS - COMP/OP AGG
$ 2,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON -OWNED AUTOS
DT8100605C718TIL06
10/03/2006
10/03/2007
COMINED
(Ea accidentSINGLE LIMIT
$ 1,000,000
X
BODILY INJURY
(Per person)
$ XXXXXXX
X
BODILY INJURY
(Per accident)
$ XXXXXXX
X
PROPERTY DAMAGE
(Per accident)
$ XXXXXXX
GARAGE LIABILITY
ANY AUTO
NOT APPLICABLE
AUTO ONLY - EA ACCIDENT
$ XXXXXXX
OTHER THAN EAACC_
AUTO ONLY: AGG
XXXXXXX
$ XXXXXXX
A
EXCESS LIABILITY
X OCCUR CLAIMS MADE
0 UMBRELLA
DEDUCTIBLE FORM
RETENTION $
DTSMCUP0605C718TIL06
10/03/2006
10/03/2007
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$ 1,000,000
XXXXXXX
J{}{}{xxxx
$ XXXXX} x
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
4023016
10/Ul/2006
10/01/2007
X WCSTATU- OTH-
E.L. EACH ACCIDENT
$ 100,000
E.L. DISEASE - EA EMPLOYEE
$ 100,000
E.L. DISEASE - POLICY LIMIT
1 $ 500,000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
RE: City of Fort Collins Contract No. P951. City of Fort Collins is included as Additional Insured as respects General Liability.
W
2146488
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 DAYS WRITTEN
Attn: Purchasing
215 North Mason St.
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
Ft. Collins, CO 80524
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD25-S(7I97) For questions mijarding this certificate,
contact the number listed in the 'Producer section show and sleacity the client cods '13TCON01.1 nACORDCORPORCT10N19RA