HomeMy WebLinkAboutGRANITE CONSTRUCTION - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE OP ID DATE(MWDD/YYYY)
GRA-211 04/01/05
McSherry 6 Hudson
Granite Construction Division
575 Auto Center Dr.
Watsonville CA 95076
Phone:831-724-3841 Fax:831-724-7574
INSURED
GRANITE CONSTRUCTION COMPANY
P.O. Box 50085
Watsonville CA 95077
le1911I a Olftcl Z.
Y AND
AL'
THE CERTIFICATE
'AMEND, EXTEND I
THE POLICIES BEL
INSURERS AFFORDING COVERAGE I NAIC #
INSURER A: Valley Forge Insurance Co.
INSURER B:
INSURER C:
INSURER D:
INSURER E:
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
INSRE
TYPE OF INSURANCE
POLICY NUMBER
DATE MMIDDIYY
DATE MMIDDIYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
s 2,000,000
X
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE O OCCUR
GL 2 4921 89 16
10/01/03
10/01/06
UAMAUA
PREMISES(aoccurence)
s 2,000,000
MED EXP (Any one person)
$ NIL
X Contractual Liab.
PLR ISO PoRH CG000l to/ol
PERSONAL B ADV INJURY
s 2,000,000
X
XCU Hazards
GENERAL AGGREGATE
$10,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
$ 2,000,000
POLICY jE P El LOC
A
X
AUTOMOBILE
LIABILITY
ANY AUTO
BUA 2 4921 89 47
10/01/03
10/01/06
COMBINED SINGLE LIMIT
(Ea accident)
s 2,000,000
X
BODILY INJURY
(Per person)
s
ALL OWNED AUTOS
SCHEDULED AUTOS
X
HIREDAUTOS
NON -OWNED AUTOS
BODILY INJURY
(Per accident)
$
X
X
Contractual Llab
PLR ISO PORN CA000l to/ol
PROPERTY DAMAGE
(Per accident)
s
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGO
EXCESSIUMBRELLA LIABILITY
Ten (10) Days Notice
will be
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
given in the event
of
AGGREGATE
$
DEDUCTIBLE
cancellation for non-payment
of premium
$
$
$
RETENTION $
A
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNERIEXECUTIVE
WC 2 4922 51 71
10/01/04
10/01/05
X TORY LIMITS ER
E.L. EACH ACCIDENT
s 2,000,000
E.L. DISEASE - EA EMPLOYE
s 2,000,000
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$ 2 , 000 , 000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES
(GAI/AAI) JOB #160182 FORT COLLINS SLURRY SEAL 2005 - VARIOUS LOCATIONS
IN THE CITY OF FORT COLLINS, COLORADO
CERTIFICATE HOLDER CANCELLATION
FTCOLLI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI
DATE THEREOF, THE ISSUING INSURER WILL AIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
CITY OF FORT COLLINS
P.O. BOX 580
FORT COLLINS CO 80522-0580^"'—
Policy Number: GL 2 492189 16 Valley Forge Insurance Company
Named Insured: GRANITE CONSTRUCTION COMPANY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
ADDITIONAL INSURED
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART.
SCHEDULE
Additional Insured:
City of Fort Collins, Engineer, Engineer's Consultants and their Respective
Officers and Employees
Covered Operations:
Job #160182 Fort Collins Slurry Seal 2005 — Various Locations in the City of
Fort Collins, Colorado
WHO IS AN INSURED (Section II) is amended to include as an insured the person or
organization shown in the above in the Schedule, (hereinafter called "Additional Insured'), but
only with respect to liability arising out of operations performed for the Additional Insured by the
named Insured and subject to coverage afforded by the standard Commercial General Liability
Coverage Form #CG0001 (10/01)
THIS INSURANCE POLICY WILL NOT BE CANCELLED, LIMITED, NON RENEWED, OR COVERAGE REDUCED
UNTIL THIRTY (30) DAYS AFTER RECEIPT BY THE ADDITIONAL INSURED NAMED ABOVE OF A WRITTEN
NOTICE OF SUCH CANCELLATION, REDUCTION OF COVERAGE OR NON RENEWAL. IN THE EVENT OF
CANCELLATION FOR NON-PAYMENT OF PREMIUM, TEN (10) DAYS WRITTEN NOTICE OF SUCH
CANCELLATION WILL BE GIVEN.
MCSHERRY & HUDSON
BY
Authorized Representative
DATE: 4/1105
CNA
FbrA►I the Commltrnm You M&W
Policy Number: BUA 2 4921 89 47 Valley Forge Insurance Company
Named Insured: Granite Construction Company
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
ADDITIONAL INSURED - COMMERCIAL AUTO POLICY
This endorsement adds the following "Additional Insured" solely as respects vehicles
owned or used by Granite Construction Company
Additional Insured:
City of Fort Collins, Engineer, Engineer's Consultants and their Respective Officers and
Employees
Covered Operations:
Job #160182 Fort Collins Slurry Seal 2005 — Various Locations in the City of Fort
Collins, Colorado
THIS INSURANCE POLICY WILL NOT BE CANCELLED, LIMITED, NON RENEWED, OR COVERAGE REDUCED UNTIL THIRTY
(30) DAYS AFTER RECEIPT BY THE ADDITIONAL INSURED NAMED ABOVE OF A WRITTEN NOTICE OF SUCH
CANCELLATION, REDUCTION OF COVERAGE OR NON RENEWAL. IN THE EVENT OF CANCELLATION FOR NON-PAYMENT
OF PREMIUM, TEN (10) DAYS WRITTEN NOTICE OF SUCH CANCELLATION WILL BE GIVEN.
MCSHERRY & HUDSON
BY
DATE: 04101/05