HomeMy WebLinkAboutFCI CONSTRUCTORS - INSURANCE CERTIFICATE (5)ACORD. CERTIFICATE OF LIABILITY INSURANCE 04071105°"""'
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Van Gilder Insurance Corp. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
700 Broadway, Suite 1000 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver, CO 80203
303 837-8500
INSURED
FCI Constructors, Inc.
PO Box 1767
Grand Junction, CO 81502
INSURERS AFFORDING COVERAGE NAIC #
INSURERA: Zurich North America
INSURER B: National Union Fire Ins. Co. (AIG)
INSURERc: Travelers Indemnity Company (CL)
INSURER D:
INSURER E:
v 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.
NSROD'NTYPE
LTR
NSR
OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MMIDD/YYI
POLICY EXPIRATION
DATE MMIDDIYI'
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FX OCCUR
GL0375709200
BLKT ADD'L
INSUREDS
BLKT WAIVER OF
SUBROGATION
04/01104
10101/05
EACH OCCURRENCE
$1000000
DAMAGE TO RENTED mcurrenceI
$100000
MED EXP (Any one person)
$10000
PERSONAL &ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2 000 000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY X jECT LOC
PRODUCTS - COMP/OP AGG
s2,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS, .
HIREDAUTOS
NON-OWNEDAUTOS
BAP375709100
04/01/04
10/01/05
COMBINED SINGLE LIMIT
(Ea accident)
$1 000 000
,
X
BODILY INJURY
(Par person)
$
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
B
EXCESS/UMBRELLA LIABILITY
X1 OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $ 10000
BE2911613
04/01105
10101/05
EACH OCCURRENCE
$20OOO OOO
AGGREGATE
$20OOO OOO
$
$
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNERIEXECUTIVE
OFFICERIMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
WC375709000
04/01/04
10/01/05
TATU- OTH-
X WCSLIMITS I I ER
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA EMPLOYEj
$1,000,000
E.L. DISEASE -POLICY LIMIT
1 $1,000,000
C
OTHER Builders
Risk Reporting
Form
QT660142D8844TIL04
09/30/04
09/30/05
Max Value $20,000,000
Deductible $10,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT? SPECIAL PROVISIONS
L"AZI112m_11a
City of Fort Collins
Purchasing Division
215 N. Mason Street
Fort Collins, CO 80524
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30_ 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
REPRESENTATIVE
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