HomeMy WebLinkAbout121684 CAMPANA CONSTRUCTION - INSURANCE CERTIFICATECOLORADO-BW INSURANCE Fax 19702672231 May 16 2007 01:05Pm P001/002
ACQW CERTIFICATE OF LIABILITY INSURANCE 1 DATE
05/15/� 2D 00
'RODUCER (970) 223-0924 FAX (970) 267-2231 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Community First Insurance, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1075 W Horsetooth Rd, Ste 100 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins, CO 80526
INSURERS AFFORDING COVERAGE NAIC #
INSUREo Campana Construct -Ion Corp INSURERA: Colorado Casualty Insurance 4178S
2020 Lowe, Ste 201 INSURER B;
Fort Collins, CO 90526 INSURER C:
INSURER D:
INSURER E
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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, EXCLUSIONSAND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
D'
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE tM1MrD0=
09/22/2006
POLICY EXPIRATION
DATE IMWDDnM
09/22/2007
Uwre
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
Fv
CLAIMS MADE OCCUR
CPPOS6486002
EACHOCCURR£NCE
$ 1,000,00
DAMAGE TO RENTED
S ZOO 00
MED EXP (Pry one pereon)
$ 5,00
PERSONAL SADV INJURY
$ 1,000,00
GENERAL AGGREGATE
$ 2,000100
GEWL AGGREGATE LIMIT APPLIES PER:
PRO
POLICY JEC LOC
PRODUCTS. COMP/OPAGG
$ 2,000,00
AUTOMOBILE
LIABILITY
ANYAUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON-OWNEDAUTOS;
COMBINED SINGLE LIMIT
(£a accident)
$
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per ecdtlent)
$
PROPERTYDAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY -EA ACCIDENT
$
07RERTHAN EAACC
AUTO ONLY: AGG
$
$
EXCESSILIMBRELLA LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
$
$
$
WORKERS COMPENSATION AND
ENPLOYBRV IJAMLITY
ANY PROPRIETORlPAR7NERfEXECUTNE
OPPICER/MEMBER EXCLUDED?
K yes, describe under
SPECIAL PROVISIONS below -
P.TU- OTH-
TWO BTORYL
E.L. EACH ACCIDENT
S
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMB
b
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
he certificate holder is named as an Additional Insured.
City of Fort Collins
Purchasing Department
PO Box 590
Fort Collins, CO 80522
ACORD 25 (2001/08) FAX: 221-6707
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES OF CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT.
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO ORUGATION OR LIABILITY
OF ANY KIND UPON THE IN R. ITS AGENTS OR REPRESENTATIVES.
®ACORD CORPORATION 1988
COLORADO-SW INSURANCE Fax 19702672231 May 16 2007 01:05pm P002/002
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 endomement(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.
ACORD 25 (2001108)