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HomeMy WebLinkAboutG L HOFF - INSURANCE CERTIFICATE (6)ACORM CERTIFICATE OF LIABILITY INSURANCE �0/4104°°"YY"' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4821 Wheaton Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O Box 270370 Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: Travelers Insurance G.L. Hoff Co. INSURERS: Pinnacol Assurance 1815 W 12th Street P.O. Box 7448 INSURER C: Loveland, CO 80537 INSURER D: INSURER E: GUVtKAGtJ 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 DATE MWDD/YY POLICY EXPIRATION DATE (MIWDD(YY1 LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE O OCCUR X PD Ded:2,500 C0324D9364TIL04 01/01/04 01/01/05 EACH OCCURRENCE $i QQQ QQQ DAMAGE TO RENTEO"uDPREMI ESnCe) $300 000 MED EXP (Any one person) $5 000 PERSONAL &ADV INJURY $1 000 D00 GENERAL AGGREGATE s2,000,000 GENT AGGREGATE LIMITAPPLIES PER: POLICY PRO LOC JECT PRODUCTS-COMP/OP AGG s2000000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON-OWNEDAUTOS 810784F8171TIL04 01/01/04 01/01/05 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Peraccident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ A EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMS MADE DEDUCTIBLE X RETENTION $ 10 000 CUP324D9364TIL04 01/01/04 01/01/05 EACH OCCURRENCE $2 000 000 AGGREGATE $2 00O 000 $ B EMPLOYERS' LIABILITY WORKERS COMPENSATION AND ANY PROPRIETOR/PARTNEWEXECUTIVE OFFICER/MEMBER EXCLUDED? S yee, describe under SPECIAL PROVISIONS below 2242590 01/01/04 01/01/05 X WC STATU- OTH- E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE s500,000 E.L. DISEASE - POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS RE: Bid #5878 Pedestrian Bridge and Abutments City of Fort Collins Attn: John Stephen 215 N. Mason St., Second Floor PO Box 580 Fort Collins, CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL In 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 AUTHORIZED ACORD 25 (2001/08) 1 of 2 #S296635/M269800 DJF ©AC CORP TION 1988