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Home My WebLink About168787 GOLDEN TRIANGLE CONSTRUCTION INC - INSURANCE CERTIFICATE (5)Clivi 51920 FOCI Iall 1111 ACORDTM CERTIFICATE OF LIABILITY INSURANCE 0°8129107Dmrv) PRODUCER HRH of Colorado 720 South Colorado Boulevard Suite 60ON Denver, CO 80246 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 NAIL INSURED Golden Triangle Construction, Inc. 700 Weaver Park Rd. Longmont, CO 80501 INSURER A: CNA Insurance Companies B6486 INSURERS Pinnacol Assurance 10780 INSURER c: Firemari's Fund Insurance Company 21873 INSURER D. INSURER E'. nnldi Gr:FA THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTwTHSTANDI G ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 LTR %OD'L NSRI TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE I MIDDNYI POLICY EXPIRATION DATE MM/DD/YV LIMITS 'A* ' GENERALLIABILITY TCP20228661738 12/31/06" 12/31/07 EAOHOCOURRENCE- -- S1'000'000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 51 OCCUR PRMM SETO REoNTEDn $500 OOO MED EXP (Any one person) $5 000 I PERSONAL &ADV INJURY $1000000 GENERAL AGGREGATE s2,000,000 GEN' L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $2000000 POLICY X PRO X LOU A AUTOMOBILE LIABILITY ANY AUTO C2022866741 12/31/06 12/31/07 COMBINED SINGLE LIMIT IEa..ident) $1,000,00O X BODILY INJURY (Per person) S ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) S HIREDAUTOS NON -OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ Physical Damage ACV less Died GARAGE LIABILITY AUTO ONLYEAACCIDENT $ OTHER THAN EA ACC S ANY AUTO I $ AUTO ONLY. AGO A EXCESSIUMBRELLA LIABILITY CUP2022866786 12/31/06 12/31/07 EACH OCCURRENCE S5000000 X OCCUR 7 CLAIMS MADE I AGGREGATE $5 00O 000 $ S DEDUCTIBLE $ X RETENTION $ 10 000 B-'WORKERSCOMPENSATIONAND-- ----4013024-- _10/01/07-_ .-10/01/08.. _--X I WCSTATOTH- Uj. EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE ' E.L. EACH ACCIDENT $1 000006 E.L. DISEASE - EA EMPLOYEE S1,000,000 OFFICER/MEMBER EXCLUDED? It yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $1 00O 000 C OTHER Leased Wor MX198474539 01/01/07 01/01/08 $100,000 Rented Equipment I $1,000 Ded Owned Equipment ACV DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS " The following cancellation conditions always apply: -10 days for non-payment of premium - If policy shown, 10 days for Workers' Compensation for fraud; material misrepresentation; non-payment of premium; other reasons approved by the Commissioner of Insurance City of Ft. Collins 215 N. Mason PO Box,580 Fort Collins, CO 80524 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXI DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL "r+n DAYS W NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO I IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENT; REPRESENTATIVES. ACORD 26 (2001/08) 1 of 2 #M548578 I 8CMAR o 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-S (2001108) 2 of 2 #M548578