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G L HOFF - INSURANCE CERTIFICATE (7)
ACORDTM CERTIFICATE OF LIABILITY INSURANCE 1DATE 0/4/00/4/0MJDD/YYYY) 4 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood 8, Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4821 Wheaton Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O Box 270370 Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: Travelers Insurance G.L.Hoff INSURERS: Pinnacol Assurance 1815 W 12th Street P.O. Box 7448 INSURERC: Loveland, CO 80537 INSURER D: INSURER E: 1 wvmR wca 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 DATE MWDD/YY POLICY EXPIRATION DATE (MINDDIM LIMITS A GENERAL LIABILITY C0324D9364TIL04 01/01/04 01/01/05 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE O OCCUR DAMAGE TO RENTEOCC,D a300 000 MED EXP (Any one person) $5 000 X PD Ded:2,500 PERSONAL B ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY PECTRO LOC J PRODUCTS -COMPJOP AGG $2000000 A AUTOMOBILE LIABILITY ANY AUTO 810784F8171TIL04 01/01/04 01/01/05 COMBINED SINGLE LIMIT (Ea accident) a1,000,000 X ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ HIREDAUTOS NON-OWNEDAUTOS X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY -EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG A EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMS MADE CUP324D9364TIL04 01/01/04 01/01/05 EACH OCCURRENCE s2000O00 AGGREGATE $2 00O 000 DEDUCTIBLE X RETENTION $ 10 000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 2242590 01/01/04 01/01/05 X WC STATU- I OTH- E.L. EACH ACCIDENT $500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE • FA EMPLOYE $500,000 E.L. DISEASE -POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE: Bid #5878 Pedestrian Bridge and Abutments City of Fort Collins Attn: John Stephen 215 N. Mason St., Second Floor PO 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 �' n_ 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 ACORD 25 (2001/08) 1 of 2 #S296635/M269800 DJp © AC CORP TION 1988