HomeMy WebLinkAbout132158 CTL/THOMPSON INC - INSURANCE CERTIFICATE (18)ACORDTM CERTIFICATE OF LIABILITY INSURANCE 09121104°""'
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 INSURERC: Lexington Insurance Company ( UG)
Centennial, CO 80112 INSURER D:
INSURER E:
COt
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.
NSR
LTR
TYPE OF INSURANCE
POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
ATE MMIDD ATE M DD
LIMITS
A
GEHERALL1AGiLIT'Y !34UUN!:X20rvn
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FXI OCCUR
X PD Ded:1,000
w „ �i.l
1' /ul 1�l1c
,ne ^10 C? 1 0 u.,r
c nr.•i �RFnI c
Ar.v_.:. c
t1000000
FIREDAMAGE (Any onefire)
s300000
MED EXP (Any one person)
$10 000
PERSONAL A ADV INJURY
$1 000 000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIM IT APPLIES PER:
POLICY PRO- LOC
PRODUCTS - COMROP AGG
$2000000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS -
N-
NON -OWNED AUTOS
Drive Other Car
34UENTZ9366
10/01/04
10/01105
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
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
A
EXCESS LIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $10000
34XHUEX1980
10/01/04
10/01/05
EACH OCCURRENCE
56000000
AGGREGATE
$6 000 000
$
$
B
WORKERS COMPENSATION AND
EMP'_OYERS' LtASP,try
618052
10/01/04
10/01/05
X ITORY WC STATIT DER
L.L. LACH AG:IUcn 1
$500,000
E.L. DISEASE - EA EMPLOYEE
$500,000
E.L. DISEASE -POLICY LIMIT
$500,000
C
OTHER Architects 8t
ngineers
rofessional Liab
5397819
11/22/03
11/22/04
$2,000,000 per claim
$4,000,000 annl aggr.
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENOORSEMENTISPECIAL 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
SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 OAYSWRITrEN
NOTICETOTHE CERTIFICATE HOLDERNAMED TOTH E LEFT, BUTFAILURE TODOSOSHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURE RJTS AGENTS OR
REPRESENTATIVE
ue�n n APl1Dn rnDD11DATI(Nd 1ORS