Loading...
HomeMy WebLinkAbout168787 GOLDEN TRIANGLE CONSTRUCTION INC - INSURANCE CERTIFICATE (14)+ unent#: 8885 GOLUTRI ACORD- CERTIFICATE OF LIABILITY INSURANCE 10/01/04D/YYYY) PRODUCER THIS' CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HRH of Colorado ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 720 S. Colorado Blvd Ste 600-N HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 469025 Denver, CO 80246-9025 INSURERS AFFORDING COVERAGE NAIC # INSURED Golden Triangle Construction, Inc. 700 Weaver Park Rd. Longmont, CO 80501 INSURER A: CNA Insurance Companies B6486 INSURER B: Pinnacoi Assurance 10780 INSURER C: INSURER D: INSURER E: rnVFRAr:FS 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 D POLICY EXPIRATION DATE fMMIDDLYYt LIMITS A GENERAL LIABILITY TCP2022866738 12/31/03 12/31/04 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES IF, $5OO OOO MED EXP (Any one person) $5 000 CLAIMS MADE � OCCUR PERSONAL & ADV INJURY $1 000 000 GENERAL AGGREGATE $2 OOO OOO GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2 000 000 POLICY X PR' X LOC A AUTOMOBILE LIABILITY X ANY AUTO C2022866741 12131/03 12/31/04 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULEDAUTOS X HIRED AUTOS X NON-OWNEDAUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG A EXCESSIUMBRELLA LIABILITY X OCCUR CLAIMS MADE CUP2022866786 12/31/03 12/31/04 EACH OCCURRENCE s4,000,000 AGGREGATE s4,000.000 RDEDUCTIBLE $ X RETENTION $ 1 O 000 B WORKERS COMPENSATION AND 4013024 10/01/04 10/01/05 X WcSTATU- OTH- LIMITS FR EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE E.L. EACH ACCIDENT $1 00O 000 E.L. DISEASE - EA EMPLOYEE $1 000 000 OFFICER/MEMBER EXCLUDED? If yes, descdbe under E.L. DISEASE -POLICY LIMIT $1 OOO 0O0 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS 2003 Gardens on Spring Creek/ Educational Wing Addition Bid No. 5748 City of Fort Collins, Colorado, Engineer, Engineer's Consultants and any other persons or entities identified in contract supplementary (See Attached Descriptions) City of Fort Collins, Colorado 300 LaPorte Avenue Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL In* 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 „wUnw co IcwuUG) 1 of 3 #M225812 TMR © 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. AwrcU za-s (xuuvud) 2 of 3 #M225812 DESCRIPTIONS (Continued from Page 1) conditions are Additional Insureds as respects to General Liability, Auto Liability and Umbrella Liability only if required by written contract and coverage applies only as respects ongoing operations performed by Insured for the Certificate Holder. All coverage terms, conditions and exclusions of the policy apply. Cancellation Clause & Materialy Altered amended: will mail $0 days written notice to the Certificate Holder. 10 days notice will be given for non-payment of premium. KMO ca.s kcw MUD) 4 OT 3 iFMZLoti7Z