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Home My WebLink AboutCONSTRUCTION CONCEPTS - INSURANCE CERTIFICATE (4)ACORD CERTIFICATE OF LIABILITY INSURANCE ID S DATE 22 COOP NST-1 08 03) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Linden/Bartels & Noe Agency FC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1614 Oakridge Drive, Unit A ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fort Collins CO 80525 Phone: 970-229-9304 Fax:970-229-1398 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: Auto —Owners Insurance Co. 18988 INSURER B: Pinnacol Assurance Construction Concepts Inc. INSURER C: Marc & Kim Dewey 14125 Mead Street INSURER D: Longmont CO 80504 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMICY DDm DATE MM/DDCY EXPIRATION LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X❑ OCCUR 024632-45937816-02 - 08/24/03 08/24/04 EACH OCCURRENCE $ 1 , 000 , 000 PREMISES (Ea occurence)$100,000 MED EXP (Any one person) $ 10 , 000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PJECTRO- LOC PRODUCTS-COMP/OP AGO $2,000,000 A AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULEDAUTOS HIREDAUTOS NON -OWNED AUTOS 43-937-816-00 08/24/03 08/24/04 COMBINED SINGLE LIMIT (Ea accident) $ 1 , 000 , 00 0 BODILY INJURY (Per person) $ X X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANYAUTO 1 AUTO ONLY - EA ACCIDENT S OTHER THAN EA ACC AUTO ONLY: AGO $ $ A EXCESSIUMBRELLA LIABILITY X I OCCUR �CLAIMSMADE DEDUCTIBLE RETENTION $ 43-937-816-01 08/24/03 08/24/04 EACH OCCURRENCE s2,000,000 AGGREGATE 52,000,000 $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? IfIns under SPECIAL PROVISIONS below 4031745 08/C1/03 OB/O1/04 _ X TORY LIMITS ER E.L. EACHACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100 , 000 E.L. DISEASE -POLICY LIMIT a500, 000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS aicnr rrrvr+r c nvcvcr� -- FT COLL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 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 City of Ft. Collins P.O. Box 580 REPRESENTATIVES. Ft. Collins CO 80522 AUTHORIZED REPRESENTATIVE e Michael D. Pierce I ACORD 25 (2001106) RPORATION 198E ACM CERTIFICATE OF LIABILITY INSURANCE OP ID S DATE(MM/DD/YYYY) CONST-1 08 22 03 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Linden/Bartels & Noe Agency FC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1614 Oakridge Drive, Unit A ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fort Collins CO 80525 Phone: 970-229-9304 Fax: 970-229-1398 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: Auto -Owners Insurance Co. 18988 INSURERS: Pinnacol Assurance Construction Concepts Inc. Marc & Kim Dewey 14125 Mead Street Longmont CO 80504 INSURER C: NSURER DD 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. LTR NSR TYPE OFINSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MFFECTY DATE MMND LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X❑ OCCUR 024632-45937816-02 08/24/03 08/24/04 EACH OCCURRENCE $ 1 , 000 , 000 PREMISES (Ea occurence) $100,000 MED EXP (Any one person) $ 10,000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 17 POLICY PROJECT LOC PRODUCTS - COMP/OP AGG s2,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS 43-937-816-00 08/24/03 08/24/04 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ X X BODILY INJURY (Per accident) $ X PROPERTYDAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ A EXCESS/UMBRELLA LIABILITY X OCCUR 1-1CLAIMSMADE DEDUCTIBLE RETENTION $ 43-937-816-01 08/24/03 08/24/04 EACH OCCURRENCE s2,000,000 AGGREGATE s2,000,000 $ $ B WORKERS COMPENSATION AND ANY PROPRtETOFPJPARTNER/EXECUTIVE EMPLOYERS'LIABILITY ETORI OFFICER/MEMBER EXCLUDED? Des. describe under SPECIAL PROVISIONS below 4031745 08/01/03 08/01/04 X TORY LIMITS ER E.L. EACH ACCIDENT $100,000 E.L. DISEASE - EA EMPLOYEE $ 100 , 000 E.L. DISEASE -POLICY LIMIT 1 $500, 000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS fax#224-6134; Certificate holder is named as Additional Insured. CERTIFICATE HOLDER CANCELLATION FTCOLLI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL City of Ft. Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR P.O. BOX 580 .REPRESENTATIVES, AUTHORIZED REPRESENTATIVE Ft. Collins, CO 80522 Michael D. Pierce AL;UMLJ 25 (Zu0vu8) I CORPORATION 1988