HomeMy WebLinkAboutPINKARD - INSURANCE CERTIFICATE (2)ACORU CERTIFICATE OF LIABILITY INSURANCE
DATE/07 /YY)
Ol/18/07
PRODUCER 1-303-534-4567
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
The INA Financial Group, Inc.
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
INA of Colorado, Inc.
1550 17th Street
Suite 600
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver, CO 80202
INSURERS AFFORDING COVERAGE
INSURED
Pinkard Construction
INSURER A: National Union Fire Ina. CO. of PA (AIG)
INSURER B: Illinois union Ins CO (ACE American Ins Cc)
9195 West 6th Avenue
INSURER C: PinnaC01 Assurance
INSURERD:Zurich American Insurance company
Lakewood, CO 80215
INSURER E:
cc
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 (101111111101M
11/01/06
POLICY EXPIRATION
DATE INIMIDDIM
LIMITS
D
GENERAL LIABILITY
GL0369651202
11/01/07
EACH OCCURRENCE
$ 1,000,000
FIRE DAMAGE (Any one fire)
$ 300,000
X COMMERCIAL GENERAL LIABILITY
MED EXP (Any one pareon)
$ 10,000
CLAIMS MADE 1XI OCCUR
X BI/PD Ded: $50, 000
PERSONAL a ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$2,000,000
POLICY r X PRO LOC
D
AUTOMOBILE
LIABILITY
ANY AUTO
BAP369651302
11/01/06
11/01/07
COMBINED LIMIT
a accident)
(E
$1, 000, 000
X
BODILY INJURY
(Per parson)
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Par accident)
$
HIRED AUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
A
EXCESS LIABILITY
X OCCUR CLAIMS MADE
BE7227889
11/01/06
11/01/07
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$ 1,000,000
$
AXDEDUCTIBLE
RETENTION $ 10, 000
$
C
WORKERS COMPENSATION AND
2321400
10/01/06
10/01/07
X WC STATU- OTH-
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$ 100,000
E.L. DISEASE - EA EMPLOYEE
$ 100,000
E.L. DISEASE -POLICY LIMIT
$500,000
OTHER
B
Professional Liability
Pollution Liability
$2,000,000 Shared Lmt
CROG23567519002
with Pollution I
11/01/06
11/01/07
Each Claim $ 2,000,000
Aggregate $ 2,000,000
Each Claim Ded. $ 25,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
City of Fort Collins, Colorado is included as Additional Insured on the General Liability Policy as required by
written contract or agreement and with respect to work performed by Insured.
RE: CONSTRUCTION OF A 49,980 SQ. FT. NORTHSIDH AZTLAN
CANTER LOCATED AT 112 EAST WILLOW STREET, FORT COLLINS, CO
City of Fort Collins, Colorado
215 North Mason Street, 2nd Floor
PO Box 580
Fort Collins, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 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
AUTHORIZED REPRESENTATIVE
USA
ACORD 25-S (7/97) elespron
rcl
TInN 109A
0
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.