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Home My WebLink About166269 GARNEY CO - INSURANCE CERTIFICATE (4)his certificate is executed by Liberty Mutual Insurance Group as respects such insurance as is attorded by those companies. BM0068 Certfcate of Insurance This certificate is issued as a matter of information only and confers 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 c not nhered by nnv rennirement term nr rnnditinn of anv rnntrari nr nrhen dnrnmn..,i .vVrh ,w.rnen n, v.h;rh rh;c Exviration Tvve Continuous* Extended Policy Term JX Workers Compensation General Liability HClaims Made X Occurrence a all their terms. exclusions and conditions and EffJExp. Date(s) Policy Number(s) Limits of Liability_ 10/01/2006 / 10/01/2007 WA2-14D-426942-736 Coverage afforded under WC law of Employers Liability the following states: Bodily Injury By Accident AR, AZ, CO, FL, GA, KS, KY, MO, NE, $1,000,000 Each Accident OK, SC, SD, TN, TX, UT, WY Bodily Injury By Disease $1,000,000 Policy Limit Bodily Injury By Disease $1,000,000 Each Person 10/01/2006 / 10/01/2007 1 TB2-141-426942-726 I General Aggregate -Other than Prod/Completed Operations Products/Completed Operations Aggregate Bodily Injury and Property Damage Liability I Per Retro Date Personal and Advertising Injury Per Person / $1,000,000 Or anizatior Other Liability Other Liability $300,000 Fire Legal $10.000 Medical 10/01/2006 / 10/01/2007 AS2-141-426942-716 Each Accident - Single Limit - B. I. and P. D. Combined Automobile Liability X Owned X Non -Owned X Hired Each Person Each Accident or Occurrence Each Accident or Occurrence C I *WA Policy includes deductible endorsement with $250,000 deductible per occurrence/claims (disease) with the provision that Liberty Mutual will (may) advance payment O the deductible amount. -- Project: Nelson Farm Pond -Soil Haul. City of Fort Collins, Colorado is additional insured as respects general M liability. E N T S *If the certificate expiration date is continuous or extended term, you will be notified if coverage is terminated or reduced before the certificate expiration date. However, you will not be notified annually of the continuation of coverage. Special Notice - Ohio: Any person who, with intent to defraud or knowing 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 railing address may also be obtained by calling this number. Notice of cancellation: (not applicable unless a number of days is entered belowl . 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 mailed to: Office: OVERLAND PARK, KS Phone: 913-681-1700 Certificate Holder: City of Fort Collins, Colorado 4316 LaPorte Avenue Fort Collins, CO 80522 CHRISTINA GRAVELY Date Issued: 09/11/2006 Prepared By: CH This Certificate of Insurance This certificate is issued as a matter of information only and confers no rights upon you the certificate holder. This certificate is not an insurance policy and does not amend, extend, or alter the coverage This is to certify that (Name and address of Insured) GARNEY CONSTRUCTION 10822 W TOLLER DRIVE, SUITE 100 LITTLETON, CO 80127 a, at the issue date of this certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ies) is subjec is not anerea ov anv reouaemem. term or E iration Tvve Continuous* Extended Policy Tenn JX Workers Compensation General Liability HClaims Made X Occurrence Retro Date Automobile Liability X Owned X Non -Owned % Hired 10/01/2006 / 10/01/2007 1 WA2-14D-426942-736 10/01/2006 / 10/01/2007 1 TB2-141-426942-726 10/0112006 / 10/01/2007 1 AS2-141426942 716 be issued. tMr- to all their terms, exclusions and conditions and Limits of 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 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 Per $1,000,000 Occurrence Personal and Advertising Injury Per Person / $1.000,000 Or anizatior Other Liability Other Liability $300,000 Fire Legal $10,000 Medical Each Accident - Single Limit - B. I. and P. D. Combined $1,000,000 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. -- Project: Dry Creek Drainage Improvements - Larimer County Canal Improvements/Reservoir #3 Gate Structure. City of Fort Collins, Colorado, Water M Supply and Storage Company, Windsor Reservoir and Canal Company and URS Corporation, Inc- are additional insured as respects general M liability. E N T S -n me certificate expiration date is continuous or extended term, you will be notified if coverage is terminated or reduced before the certificate expiration date. However, you will not be notified annual] the continuation of coverage. Special Notice - Ohio: Any person who, with intern to defraud or knowing 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 holden;: 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 comer of this certificate. The appropriate local sales office mailing address may also he 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 mailed to: Office: OVERLAND PARK, KS Phone: 913681-1700 Certificate Holder: City of Fort Collins, Colorado 4316 LaPorte Avenue Fort Collins, Co 80522 CHRISTINA GRAVELY Date Issued: 09/11/2006 Prepared By. CH 'his certificate is executed by Liberty Mutual Insurance Group as respects such insurance as is afforded by those companies. BM0068 Certificate of Insurance This certificate is issued as a matter of information only and confers no rights upon you the ceti:icate holder. This certificate is not an insurance policy and dos 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 s, at the issue date of this certificate, insured by the Company under the pohcy(is) listed below. The insurance afforded by the listed policy(is) is subject i rs not aneren oy any requirement, term Exviration Typ Continuous* Extended X Policy Term Workers Compensation General Liability HClaims Made X Occurrence .� Liberty7 .t� cil m all their terms, exclusions and conditions and EffJExp. Date(s) Policy Number(s) Limits of Liability 10/01/2006 / 10/01/2007 WA2-14D-426942-736 Coverage afforded under WC law of Employers Liability the following states: Bodily IRlt'Y B u Accident y AR, AZ, CO, FL, GA, KS, KY, MO, NE, $1,000,000 Each Accident OK, SC. SD, IN, TX, Ur, WY Bodily Injury By Disease $1,000,000 Policy Limit Bodily Injury By Disease $1,000,000 Each Person 10/01/2000 / 10/01/2007 I TB2-141-426942-726 I General Aggregate -Other than Prod/Completed Operations Products/Completed Operations Aggregate Bodily Injury and Property Damage Liability I Per Retro Date Personal and Advertising Injury Per Person / $1,000,000 Or anizatioi Other Liability Other Liability $300,000 Fire Legal $10,000 Medical 10/01/2006 / 10/01/2007 AS2-141-426942-716 Each Accident - Single Limit - B. I. and P. D. Combined Automobile Liability X Owned X Non -Owned X Hired 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: Spring Creek Pre -Disaster Mitigation BNRR Embankment Stabilization. City of Fort Collins, Colorado is additional insured with respect to M general liability where required by written contract. M E N T S *If the certificate expiration date is continuous or extended term, you will be notified if coverage is terminated or reduced before the certificate expiration date. However, you will not be notified annually of the continuation of coverage. Special Notice - Ohio: Any person who, with intent to defraud or knowing that he / she is facilitating a fraud against as 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 time and telephone number appears in the lower left corner of this certificate. The appropriate local sales office mailing address my 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 a[ least 60 days notice of such cancellation has been mailed to: Office: OVERLAND PARK, KS Phone: 913-681-1700 Certificate Holder: City of Fort Collins 4316 LaPorte Avenue Fort Collins, CO 80522 A— 3:.1f _ CHRISTINA GRAVELY Date Issued: 09/11/2006 Prepared By: CH This certificate is executed by Liberty Mutual Insurance Group as respects such insurance as is afforded by those companies. BM0068 Certificate of Insurance This certificate is issued as a matter of information only and confers 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 requirement, term or condition of any contract or other document with respect to which this certificate may be issued. Exniration Tvne Continuous* Extended Policy Term JX Workers Compensation 10/01/2006 / 10/01/2007 1 WA2-14D-426942-736 10/01 /2006 / 10101/2007 1 TB2-141-426942-726 .Yw to all their terms, exclusions and conditions and Limits of 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 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 General Liability $2,000,000 Products/Completed Operations Aggregate $2,000,000 HClaims Made Occurrence X Bodily Injury and Property Damage Liability $1,000,000 Per Occurrence Retro Date Personal and Advertising Injury $1,000,000 Per Person / Or ani7atioi Other Liability $300,000 Fire Legal Other Liability $10,0()0 Medical Automobile Liability 10/01/2006 / 10/01/2007 AS2-141-426942-716 Each Accident - Single Limit - B.1. and P. D. Combined $1,000,000 Each Person X Owned X Non -Owned X Hired 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. -- Project: Sitting Creek Pedestrian Bridge. The City of Fort Collins is additional insured with respect to general liability where required by written M contract. M E N T S -n me cemncate expiration date is continuous or extended term, you will be notified if coverage is terminated or reduced before the certificate expiration date. However, you will not be notified annually of' the continuation of coverage. Special Notice - Ohio: Any person who, with intent to defraud or knowing that he / she is facilitating a fraud against an insurer, submits m 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 let! corner of this certificate. The appropriate local sales office mailing address may also be obtained by calling this number. Noticeof cancellation: (not applicable umess 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 mailed to: Office: OVERLAND PARK, 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