HomeMy WebLinkAbout132158 CTL/THOMPSON INC - INSURANCE CERTIFICATE (17)ACORQM CERTIFICATE OF LIABILITY INSURANCE 1DATE 1/19/04�Y)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Van Gilder Insurance Corp. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
700 Broadway, 1000 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
y ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver, CO 80203
303 837-8500 INSURERS AFFORDING COVERAGE
INSURED INSURER A: Hartford Insurance Group
CTL/Thompson, Inc. INSURER B: Pinnacol Assurance
7306 S. Alton Way INSURER c: Lexington Insurance Company (AIG)
Centennial, CO 80112
INSURER D:
INSURER E:
COVERAGES
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.
INSR
LTR
rypE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM/DD/YY
'POLICY EXPIRATION
DATE MM/DD/YY
LIMITS
A
GENERAL LIABILITY
X COMMERCIALGENERALLIABILITY
CLAIM5 MADE ( UCCUH
X PD Ded:1,000
34UUNEX2070
10/01/04
10/01/05
EACH OCCURRENCE
$1 000 000
FIRE DAMAGE (Anyone fire)
$300000
-MED EY.P (Airy one persun)
1 $1 O 000
PERSONAL B ADV INJURY
$1000000
$2 OOO OOO
GENERAL AGGREGATE
GEN'L AGGREGATE LIM IT APPLIES PER:
1-1 POLICY PROT LOC
EC
PRODUCTS -COMP/OP AGG
s2,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON -OWNED AUTOS
Drive Other Car
134UENTZ9366
10/01/04
.
10/01/05
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY $
(Per accident)
X
X
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHERTHAN EA ACC
AUTOONLY: AGG
$
$
A
EXCESS LIABILITY
X OCCUR 11 CLAIMS MADE
DEDUCTIBLE
X RETENTION $10000
34XHUEX1980
10/01/04
10/01/05
EACH OCCURRENCE
$6 OOO OOO
AGGREGATE
s6,000,000
$
$
B WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
'.
618052
10/01/04
10/01/05
X WC STOTH-
T RY LIMI MIT ER
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE - EA EMPLOYEE
$500,000
E.L. DISEASE - POLICY LIMIT
_
$500,000
C
OTHER Architects &
Engineers
Professional Liab
0741679
11/22/04
11/22/05
$2,000,000 per claim
$4,000,000 annl aggr.
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
City of Ft. Collins, Purchasing Division is listed as an Additional Insured,
under General Liability only, in respects to their interest in work performed
by the insured as per written specified contracts.
City of Ft. Collins
Purchasing Division
P.O. Box 580
Fort Collins, CO 80522
Annon qce i�rnT. �...............
SHOULD ANYOFTH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TH E EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL -in DAYSWRITTEN
NOTICETOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTFAILURE TODOSOSHALL
IMPOSE NOOBLIGATION OR LIABILITYOF ANYKIND UPON THE INSURERJTS AGENTS OR