HomeMy WebLinkAboutCORRESPONDENCE - BID - 5681 2202988 FOSSIL CREEKri i PTltft • R9c,2
MARYVOTT
ACOR � CERTIFICATE OF
LIABILITY
INSURANCE
o9ii9/02
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF
INFORMATION
HRH of Deriver
ONLY AND CONFERS NO RIGHTS UPON THE
CERTIFICATE
720 S. Colorado Blvd Ste PH N
HOLDER. THIS CERTIFICATE DOES NOT AMEND,
ALTER THE COVERAGE AFFORDED BY THE POLICIES
EXTEND OR
BELOW.
P.O. Box 469025
(Denver, CO 80246-9025
INSURERS AFFORDING COVERAGE
INSURERA:Travelers Insurance Company
INSURED
Mark Young Construction, Inc.
155 N. College Ave., Suite 220
---
INSURERB:Fireman s Fund Insurance
Company
----------------
INSURERD:Pinnacol Assurance
(Fort Collins, CO 80524
INSURER D:
INSURER E:
I
[Ka1TIX.7_[N3-�
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
TYPE OF INSURANCE
POLICYNUMBEq
POLICY EFFECTIVE
POATEIMMI PIRA1YY1
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
DTC0584X287901
12/31/01
12/31/02
EACH OCCURRENCE
$1 000, 000
FIRE DAMAGE (Any one lira
$ 300, 000
MED EXP (Anyone person)
_
$
PERSONAL E ADV INJURY
$1, 000, 000
GENERAL AGGREGATE
$2 000 000
GENTAGGREGATE LIMIT APPLIESPER:
POLICY X PRO X LOC
_PRODUCTS-COMP/OPAGG
$2,_ 000, 000
A
AUTOMOBILE
LIABILITY
ANYAUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON -OWNED AUTOS
DTJ810324D934001
12/31/01
12/31/02
COMBINED SINGLE LIMIT
(Ea accdent)
El, 000, 000
X
BODILY INJURY
(Per person)
$
X
BODILYINJURY
(Per accident)
$
_X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANYAUTO
AUTO ONLY -EA ACCIDENTS
OTHERTHAN EA ACC
AUTO ONLY: AGG
$
$
B
EXCESS LIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION EO
XEK84853233
12/31/01
12/31/02
EACH OCCURRENCE
s3 000,000
AGGREGATE
s3,000,000
$
E
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
Officers Included
4016391
01/01/02
01/01/03
X We STATU OTH-
--
E 500, 000
E.L. EACH ACCIDENT
E. L. DISEASE -EA EMPLOYEE
$ 500, 000
E.L. DISEASE -POLICY LIMIT
$ 500 000
OTHER
i
I
i
i
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDE D BY ENDORSEMENT/SPECIAL PROVISIONS
Utility Service Center -Warehouse Storage Improvements, 700 Wood Street
(Fort Collins, CO
City of Fort Collins
215 North Mason Street, 2nd
Floor
Fort Collins, CO 80524
SHOULDANYOFTHE ABOVE DESCRIBEDPOUCIES BE CANCELLED BEFORETHE EXPIRATION
DATETHEREOF,THE ISSUING INSURER WILL ENDEAVORTO MAIL; n _ DAYS WRITTEN
NOTICETOTHE CERTIFICATE HOLDER NAMED TOTHE LEFT, BUTFAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILgKOFANYKIND UPON THE INSURERITSAGENTSOR
AUTHORIZED
4CORD25•S(7197)1 of 2 #S141335/M125874
DVG 0 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.
25-S(7197)2 of 2 #S141335/M125874