HomeMy WebLinkAbout109256 BARKER CONSTRUCTION CO INC - INSURANCE CERTIFICATE (14)DATE
ACORD.M CERTIFICATE OF LIABILITY INSURANCE 05/04/050nvvv)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood &Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
4821 Wheaton Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P 0 Box 270370
Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC #
INSURED
Barker Construction Company, Inc
142 North Timberline Road
Fort Collins, CO 80524
INSURERA: LUFICn
INSURERB: Pinnacol Assurance
INSURER C:
INSURER D:
INSURER E:
COVERAGtS
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
NSRE
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE JMWDDNYI
POLICY EXPIRATION
DATE MMIDDIYY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE � OCCUR
CP0375786002
05/01/05
05/01/06
EACH OCCURRENCE
$1 000000
DAMAGE TORENTED n
MI
$300OOO
MED EXP (Any one person)
$10OOO
PERSONAL & ADV INJURY
$1 OOO OOO
GENERAL AGGREGATE
$2 000 000
PRODUCTS - COMP/OP AGG
$2 000 OOO
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY x PROJECT MLOC
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULEDAUTOS
HIREDAUTOS
NON -OWNED AUTOS
CP0375786002
05/01/05
05/01/06
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
X
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
A
B
EXCESS/UMBRELLA LIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $ O
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
AUC375786102
4033353
05/01/05
10101 /04
05/01/06
10/01 /05
EACH OCCURRENCE
$5000000
AGGREGATE
$5 OOO 0OO
$
$
X we STA iT- oTH-
$
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE - EA EMPLOYEE
$500,000
E.L. DISEASE - POLICY LIMIT
1 s500,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Certificate holder is named as additional insured, but only as respects
liability arising out of work performed by the named insured (Excluding
Workers' Compensation).General liability coverage is primary and
non-contributory.
City of Fort Collins
Purchasing Department
PO Box 580
Ft Collins , CO 80522
LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10_ 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
ACORD 25 (2001/08) 1 of 2 #M314082 iL'„ " ` 1v �v' �'� '�" '""-
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.
ACORD 25S (2001108) 2 of 2 #M314079