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Home My WebLink AboutGLH CONSTRUCTION - INSURANCE CERTIFICATE (5)ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID MA DATE(MMIDD/YYYY) GLHCO-1 1 03/29/05 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rich & Cartmill Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE of Colorado LLC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O Box 336416 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Greeley CO 80633 Phone: 970-356-8030 Fax:970-356-8032 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Bituminous Insurance Cos INSURER B: Pinnacol Assurance GLH Construction, Inc. Black & Silver Exits., LLC INSURER C: 780 E. Garden Drive INSURER D: Windsor CO 80550 INSURER Et COVFRAGFS 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. mamPOLICY LTR INS TYPE OF INSURANCE POLICY NUMBER EFFECTWIc. DATE MMID POLWY EXPIRATION DATE MM/D LIMITS A X GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X❑ OCCUR CLP3208523 04/01/05 04/01/06 EACH OCCURRENCE $1,000,000 PREMISES iEa occurence) $ 100,000 MED EXP (Any one person) -$ 10,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 17 POLICY X , EC LOC PRODUCTS - COMP/OP AGG $ 2 , 000 , 000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CAP3208524 04/01/05 04/01/06 COMBINED SINGLE LIMIT (Es accident) $l,000,OOO X BODILY INJURY (Per person) $ BODILY INJURY (Per aoddent) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ A EXCESS/UMBRELLA LIABILITY X OCCUR F�CLAIMSMADE DEDUCTIBLE RETENTION $ CUP2575357 04/01/05 04/01/06 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 $ $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILRY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? I es, describe under SPECIAL PROVISIONS below 4028616 07/01/04 07/01/05 TORY LIMITS X ER E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE $ 5 0 0 , 0 00 E.L. DISEASE -POLICY LIMIT $ 500,000 A OTHER Property Policy CLP3208523 04/01/05 04/01/06 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City of Ft. Collins is an Additional Insured on the General Liability, but only with respects to liability arising out of the insureds operations. KPETERS 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 City of Fort Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY IOND UPON THE INSURER, ITS AGENTS OR P.O. Box 580 Fort Collins CO 80522-0580 REPRESENTATIVES. 25 (20011081 0 ACORD CORPORATION 1999 ACORD,. CERTIFICATE OF LIABILITY INSURANCE (MMJD 0DATE 4/05105DIYYYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Ins. Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P. 0. Box 578 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 4687 W. 18th Street Greeley, CO 80632 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: Zurich GLH Construction, Inc. Black & Silver Ents., L.L.C. INSURER B: 780 E. Garden Drive INSURER C: Windsor, CO $0550 INSURER D: INSURER E: 4uvc "CJ 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. IN LTR INSRN TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MWDDIYYI POLICY EXPIRATION DATE D LIMITS A GENERAL LIABILITY CP0375796001 09/13/04 04/01/05 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 51OCCUR DAMAGE TO RENTEDPREMISE (E. s300 000 MED EXP (Any one person) $10 000 PERSONAL & ADV INJURY $1 00Q 000 X BI/PD Ded:10000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 POLICY PRO- LOC JECT A AUTOMOBILE LIABILITY ANY AUTO CP0375796001 09/13/04 04/01/05 COMBINED SINGLE LIMIT (Ea accident) $l,000 ,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS CANT L ED X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTOONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND YdC STA?U- OTH- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYEE $ OFFICERIMEMBER EXCLUDED? If yes, describe under E.L. DISEASE - POLICY LIMIT I $ SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City of Ft. Collins is an Additional Insured on the General Liability, but only with respects to liability arising out of the insureds operations. City of Ft. Collins P O 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 _ 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 REPRESENTATIVE l"/60 ( '+r' AA..4.rs0nJ .��+i✓ra..l✓ca :Z111,,+e. MI WMU AD %(VY I/Y8) 1 of Z #M311109 PXP O 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. .�� ,, c orc smsiiiea