HomeMy WebLinkAboutGE JOHNSON CONSTRUCITON COMPANY - INSURANCE CERTIFICATEClient#: 20042
GEJOHNS
ACORD. CERTIFICATE OF LIABILITY
INSURANCE
DATE OmI
10I01107
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
IMA of Colorado, Inc.
1550 17th Street, Suite 600
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver, CO 80202
303 534-4567
INSURERS AFFORDING COVERAGE
INSURED
G.E. Johnson Construction Company, Inc.
Attn: Accounts Payable
25 North Cascade Avenue, Suite 400
Colorado Springs, CO 80903
INSURER A' Travelers Indemnity Company
INSURER B: Travelers Prop. Cas Co of America
INSURERQ Argonaut Insurance Co(Pinnacol)
INSURER D: Pinnacol Assurance
INSURER E:
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
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDD"I
POLICY EXPIRATION
DATE MMIDDIYY
LIMITS
A
_
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FX7OCCUR
X PD Ded:25000
DTC00670C701IND07
10/01/07
10101/08
EACH OCCURRENCE
$1000000
,FIRE DAMAGE (Any one fre)
.S3000QQ
MED EXP(AnYooe person)
1 S$000
PERSONAL B ADV INJURY
$1 OQQ QQQ
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE L IM ITAPPL TES PER:
IRO -
POLICY X HFC LOC
PRODUCTS-COMP/OPAGG
$2000000
B
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
DT8100670C701TIL07
10/01/07
10101/08
COMBINED SINGLE LIMIT
(Ea accident)
s1,000,000
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per acddenN
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
S
OTHER THAN EA ACC
AUTO ONLY'. AGG
S
S
B
[_EXCESS LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
hX RETENTION $10000
DTSMCUP0670C701TIL
10101/07
10/01/08
EACH OCCURRENCE
$5000000
AGGREGATE
s5,000,000
S
S
$
C
D
WORKERS COMPENSATION AND
EMPLOVERS'LIABILITY
7711822270-CA Only
4048587-CO Only
10101/07
10
10/01/08
10/01/08
X WCSTATuCRY LIM - OTH-
ER
I
E.L. EACH ACCIDENT
S1OO,000
E.L. DISEASE - EA EMPL OVEE
$100,000
E.L. DISEASE -POLICY LIMIT
1 s500,000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSME:HICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Re: All Operations.
City of Fort Collins
PO Box 580
Fort Collins, CO 80522
ACORD 25-S (71971e -f 9 RUTARAIA
SHOULD ANYOF TH E ABOVE D ESCRIBED POLICIES BE CANCELLED BEFORE TH E EXPIRATION
DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TOMAIL 30_ DAYSWRITTEN
NOTICETOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTPNLURE TODOSOSHALL
IMPOSE NOOBLIGATION OR LIASILITYOF ANY KIND UPON THE INSURERJTS AGENTS OR
REPRESENTATIVE
nnl RA @
'IdIRS
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.
ACORD25S(7/97)2 of 2 #M358434