HomeMy WebLinkAbout166269 GARNEY CO - INSURANCE CERTIFICATE (3)'his certificate is executed by Liberty Mutual Insurance Group as respects such insurance as is afforded by those cot -es. tlMUum
Certificate of Insurance
This certificate is issued as a matter of information only and wafers 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 reauirement, term or
ExDiration TvDe
Continuous*
Extended
Policy Term
X
Workers Compensation
General Liability
HClaims Made
X Occurrence
Retro Date
Automobile Liability
X Owned
X Non -Owned
X Hired
the
Of
10/01/2006 / 10/01/2007 1 WA2-14D-426942-736
10/01/2006 / 10/01/2007 1 TB2-141-426942-726
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
LtMt-
r .
all their terns, exclusions and conditions and
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
Products/Completed 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
10/01/2006 / 10/01/2007 1 AS2-141-426942-716 I 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. -- RE: Taft Hill Road Detention Pond Improvements. City of Fort Collins, Colorado is additional insured with respect to general liability where required
M by written contract.
M
E
N
T
'it me cemncate expiration date is continuous or extended term, you will be notated it coverage is terminated or reduced before the certificate expiration date. However, you will not be notitied annually of
the continuation of coverage.
Special Notice - Ohio: Any person who, with intent to defraud or ]mowing 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 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 nailed to:
Office: OVERLANDPARK,KS Phone: 913-681-1700
Certificate Holder:
City of Fort Collins
4316 LaPorte Avenue
Fort Collins, CO 80522
CHRISTINA GRAVELY
Date Issued: 09/11/2006 Prepared By: CH