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HomeMy WebLinkAboutBRINKMAN CONSTRUCTION - INSURANCE CERTIFICATEACORP. CERTIFICATE OF LIABILITY INSURANCE 03iis1Z0071 PRODUCER (970)484-0097 FAX (970)484-7077 Herbert -Ewing -Leavitt 2537 Research Blvd Suite 202 Fort Collins, CO 80S27-2289 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 BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Brinkman Construction Inc 1315 Oakridge Drive Suite 100 Fort Collins, CO 80525 INSURER A: First Mercury 10657 INSURERS: Auto Owners Ins INSURER North American Capacity 2S038 INSURERO. Pinnacol Assurance 41190 INSURER E. rnWP0 Aracc 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 ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION 02/17/2008 LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR X Blkt Addl Insureds FMFL002523 02/17/2007 EACH OCCURRENCE $ 11000,000 DAMAGE TO RENTED PREMISES (F, $ 501000 MED EXP (Anyone person) $ 51000 PERSONAL & ADV INJURY $ 11000,00 X Blkt Waiver of Sub GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PROJECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS 4674350800 03/11/2007 03/11/2008 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 BODILY INJURY (Per person) $ X X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY AGG $ $ C EXCESSIUMBRELLA LIABILITY X OCCUR ❑ CLAIMS MADE DEDUCTIBLE RETENTION $ DOX000098501 02/17/2007 02/17/2008 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 $ $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? yes, describe under BL If SPECIAL PROVISIONS below S 4093547 KT WVR OF SUBROGATION 06/01/2007 06/61/2008 1 WcsTATU- OTH- . E.L. EACH ACCIDENT $ 500, 00 E.L. DISEASE - EA EMPLOYEE $ 500, 00 E. L. DISEASE -POLICY LIMIT $ 500,00 B n 7VER Marine 7400191906 04/10/2007 04/10/2008 Rented/Leased Equipment $75,000 Limit w/$1,000 ded DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLertiES I EXCLUSIONS ADDED BY ENDORSEMENT( SPECIAL PROVISIONS ficate holder is named as additional insured as respects work performed. City of Fort Collins P 0 Box 580 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 MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001108) ©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. ACORD 25 (2001108)