HomeMy WebLinkAboutSINNETT BUILDERS - INSURANCE CERTIFICATE (13)ACORD- CERTIFICATE OF LIABILITY INSURANCE 4DATE
/15105DDmvY)
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: St. Paul Travelers Insurance Company
Sinnott Builders, Inc. INSURERS: American International Companies
P.O. Box 1969 INSURERC: Pinnacol Assurance
Fort Collins, CO 80522
INSURER D:
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.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM/DD
POLICY EXPIRATION
DATE MM/DD
LIMITS
A
GENERAL LIABILITY
DTCO283N62791ND04
06130%04
06/30/05
EACH OCCURRENCE
$1 000 000
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTEDPREMISES (Ea mcurrence)
$300 000
CLAIMS MADE a OCCUR
MED EXP (Any one person)
$5 000
PERSONAL&ADV INJURY
$1 000 000
$2,500 PD Ded.
GENERAL AGGREGATE
$2 000 000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMP/OP AGG
$2000000
POLICYERPRO LOC
JECT
A
AUTOMOBILE
LIABILITY
ANY AUTO
DT810283N6279TIL04
06/30/04 -
06130/05
COMBINED SINGLE LIMIT
(Ea accident)
$1 000
r r00�
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Per accident)
$
HIREDAUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANYAUTO
S
-
AUTO ONLY: AGG
B
EXCESS/UMBRELLA LIABILITY
BE2681534
06130/04
06/30/05
EACH OCCURRENCE
$5 000 000
-X1 OCCUR CLAIMS MADE
AGGREGATE
$5 000 000
$
$
DEDUCTIBLE
"'t
$
X RETENTION $ 10000
C
WORKERS COMPENSATION AND
4045474
07101/04
07/01/05
TATILIj TH-
X WC SLIMIT OPP
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE - EA EMPLOYEE
$500,000
OFFICERWEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE -POLICY LIMIT
$500,000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
City of Fort Collins and Poudre Fire Authorithy are named as additional insureds, but
only as respects liability arising out of ongoing operations of the named Insured
(Excluding Workers' Compensation).
City of Fort Collins
Attn: John Stephen
P. 0. Box 580
Fort Collins, CO 80522
LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN
:E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
iE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
A%,VKU AD ([UUUUD) 1 of 2 #53121861M298319 FAB 0 ACORD CORPORATION 1988