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HomeMy WebLinkAbout113752 BT CONSTRUCTION - INSURANCE CERTIFICATE (3)ACORM CERTIFICATE OF LIABILITY INSURANCE to/ol/2o07 09/26/2006) PRODUCER Lockton Companies p 8110 E Union Avenue Suite 700 CO80237 (303) 414-6000 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED ByDenver INSURERS AFFORDING COVERAGE INSURED 1047338 BT Construction, Inc.ty Attn: Michelle Ciancio 9885 Emporia Street Henderson, CO 80640 INSURER A : Travelers Prop. Casual INSURER B : Pinnacol Assurance nnvPRACPS RTrC)INJAI ArT T r; i. vc;rx;,;r is mi c ^r irvoummrmt c uura NU I UyI I I I U I E A GLIN I HAG I tlE I WEEN THE 155UING 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 MMIDD POLICY EXPIRATION DATE(MMIDDfYYIF LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FX7 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 & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES POLICY X JE0 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 CIT I '"'1 i.i 20 OF FORT COLLINS '] 6 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ XXXXXXX X BODILY INJURY (Per accident) $ XXXXXXX X PROP RTY DAMAGE $ XXXXXXX GARAGE LIABILIN ANY AUTO NOT APPLICABLE AUTO ONLY - EA ACCIDENT $ XXXXXXX OTHER THAN EA ACC AUTO ONLY: AGG XXXXXXX $ XXXXXXX A EXCESS LIABILITY X OCCUR CLAIMS MADE OUMBRELLA DEDUCTIBLE FORM RETENTION $ DTSMCUP0605C718TIL06 10/03/2006 10/03/2007 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 XXXXXXX XXXXXXX $ XXXXXXX B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY 4023016 10/01/2006 10/01/2007 X WC STATU- I E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ ] 00 000 E.L. DISEASE - POLICY LIMIT $ 500 000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVENICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS RE: Project - Bobcat Ridge Trail Parking. City of Fort Collins is included as an Additional Insured with respects to General and Auto Liability. 2562398 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 30 300 Laporte Ave. DAYS WRITTEN Fort Collins, CO 80522 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 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE r/e /v/ ../ ACORD 25-S (7/97) For questions regarding this cartlRea e, contact the number Hated in the •Pmducee section oboes and apathy the client code 13TCONe1•. © ACORD CORPORATION 1988