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Home My WebLink About168787 GOLDEN TRIANGLE CONSTRUCTION INC - INSURANCE CERTIFICATE (3)Rlinnr8• Sr09n R!_nl r1TDN ACORD,M CERTIFICATE OF LIABILITY INSURANCE DATE [MMID 12/12106DfYYYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HRH of Colorado ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 720 South Colorado Boulevard Suite 600N HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Denver, CO 80246 INSURERS AFFORDING COVERAGE NAIC # INSURED Golden Triangle Construction, Inc. 700 Weaver Park Longmont, CO 80501 INSURER A: CNA Insurance Companies B6486 INSURER B. Pinnacol Assurance 10780 INSURER c: Fireman's Fund Insurance Company 21873 INSURER D. INSURER E: 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 DD' INSRE TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDDIV POLICY EXPIRATION DATE fMMIDONYI LIMITS A GENERAL LIABILITY TCP2022866738 12/31/06 12/31/07 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 51OCCUR DAMAGE TO RENTED PREMISES Ea occurrence) $500 000 MED EXP (Any one person) $5 000 PERSONAL & ADV INJURY $1 000 000 GENERAL AGGREGATE S2 00D 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS- COMP/OP AGG $2 000 000 POUCV X PEO X LOC A AUTOMOBILE LIABILITY ANY AUTO C2022866741 12/31/06 12/31/07 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS X BODILY INJURY (Per accident) $ X Physical Damage Ded. Apply X PROPERTY DAMAGE (Per accident) $ X I ACV GARAGE LIABILITY AUTO ONLY - EA ACCIDEM $ OTHER THAN EA ACC $ ANY AUTO $ AUTOONLY: AGG A EXCESSIUMBRELLA LIABILITY X1 OCCUR CLAIMS MADE CUP2022866786 12/31/06 12/31/07 EACH OCCURRENCE s5.000.000 AGGREGATE s5,000,000 DEDUCTIBLE $ X RETENTION $ 1U 000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 4013024 10/01/06 10/01/07 X I LIMwcSTATJT I oTH- E.L. EACH ACCIDENT $1000000 ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - EA EMPLOYEE $1 00O 000 E.L. DISEASE - POLICY LIMIT $1 000 DDO C OTHER Lease Wor MX198473515 01/01/07 01/01/08 $100,000 Rented Equipment $1,000 Ded Owned Equipment ACV DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I 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 *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 --r r an 4 xIVIDDoyoo BTBEC O ACORD CORPORATION 1988 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. rwWmw'0- Jcvv uvul Z OT L PM506986