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HomeMy WebLinkAboutCONSTRUCTION CONCEPTS INC - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE OP ID L DATE(MM/DD/YYYY) CONST-1 OS 24 07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE LBN Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 4848 Thompson Pkwy ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Johnstown CO 80534 Phone:970-635-9400 Fax:970-635-9401 INSURED Construction Concepts Inc. Marc & Rim Dewey 14125 Mead Street Longmont CO 80504 INSURERS AFFORDING COVERAGE NAIC # INSURER A: EMC Insurance Companies INSURER B: Pinnacol Assurance INSURER C: INSURER D: INSURER E: 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE MM/DD/YY POLICY EXPIRATIONDATE DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE K OCCUR 3XO-95-53 08/24/06 08/24/07 PREMISES (Ea occurence) $ 100000 MED EXP (Any one person) $ 5000 X Blanket Addrl Ins CG7482 12-00 PERSONAL& ADV INJURY $1000000 Contractual Liab1 GENERAL AGGREGATE ls2000000 CG 00 01 10 01 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PROJECT LOC PRODUCTS-COMP/OP AGG $2000000 A AUTOMOBILE LIABILITY ANY AUTO 3XO-95-53 08/24/06 08/24/07 COMBINED SINGLE LIMIT (Ea accident) $ 1000000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X HIRED AUTOS X NON -OWNED AUTOS BODILY INJURY (Peraccident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ $ AUTO ONLY: AGG A EXCESS/UMBRELLA LIABILITY X OCCUR ❑CLAIMS MADE 3XO-95-53 08/24/06 08/24/07 EACH OCCURRENCE s2,000,000 AGGREGATE $2,000,000 DEDUCTIBLE E X RETENTION $ 10 , 000 $ BR WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPEC IAL PROVISIONS below 4031745 07/01/07 07/01/08 X TORY LIMITS X E E.L. EA CH ACCIDENT $1000000 E.L. DISEASE -EA EMPLOYEE $ 1000000 E.L. DISEASE -POLICY LIMIT $1000000 OTHER A Property Section 3XO-95-53 08/24/06 08/24/07 Leased & 200,000 A Equipment Floate RC ON LEASED & RENT D Rented DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Project: 6019 Community Park Sidewalks The Certificate Holder is listed as Additional Insured in regard to the General Liability. reor¢rn A r= u�l City of Fort Collins 300 LaPorte Avenue Fort Collins CO 80522 FTCOLLI I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 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 ACORD 25 (2001108) ©ACORD CORPORATION 1QAA 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. 25(2001/08)