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ADDISON CONSTRUCTION - INSURANCE CERTIFICATE (2)
ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 09/13/2006 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Ryder-Rosacker-McCue & Huston ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 509 W Koenig St ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO Box 1228 Grand Island NE 68802 INSURERS AFFORDING COVERAGE NAIC # INSURED Addison Construction Co. INSURER A: CNA Insurance 1526 Horse Creek Road INCI IRFR R Cheyenne WY 82009 COVERAGES 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 IkDD'L POLICY NUMBER POLICY EFFECTNE POLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000 000 A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE Fx_1 OCCUR C2079736848 10.1.06 10.1.07 DAMAGE TO RENTEDPREMISES (Ea oozurenoe) $ 300,000 MED EXP (Any one arson $ 5,000 PERSONAL & ADV INJURY $ 1,000 000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG s2,000,000 X I POLICY PRO LOC X AUTOMOBILE X LIABILITY ANY AUTO C2079736977 10.1.06 10.1.07 COMBINED SINGLE LIMIT (Ea aacad $ 1000,000 ,ccident) BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIREDAUTOS 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/UMBRELLA X LIABILITY OCCUR F—ICLAIMS MADE C2079736929 10-1-06 10-1.07 EACH OCCURRENCE s5,000,000 AGGREGATE $ 5,000 000 $ DEDUCTIBLE X $ RETENTION $ 10,000 WORKERS COMPENSATION AND X OTH- jWC STATU-nRyWTFR A EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE WC27936882 10.1-06 10.1-07 E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEEI $ 500,000 OFFICER/MEMBER EXCLUDED? H yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT 1 $ 50O 000 OTHER Installation Floater $5,000,000 A Contractors Equipment C2079736848 10-1.06 10-1.07 Leased/Rented Equip $150,000 $5,000 deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City of Fort Collins is an additional insured. CERTIFICATE HOLDER CANCELLATION City of Fort Collins 300 LaPorte Avenue 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 <MV> ACORD 25 (2001/08) 9 ©ACORD CORPORATION 1988