HomeMy WebLinkAbout132158 CTL/THOMPSON INC - INSURANCE CERTIFICATE (19)ACORoa CERTIFICATE OF LIABILITY INSURANCE 0DATE 1/26104Dnv)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Van Gilder Insurance Corp. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
700 Broadway, Suite 1000 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver, CO 80203
303 837-8500 INSURERS AFFORDING COVERAGE
WsuRED IN A: Hartford Insurance Group
-- - - — -- hoInc.
7971 Westst 12th Avenue INSURER B: Pinnacol Assurance
12th - -- - -
wsuRERc: Lexington Insurance Company (AIG)
Denver, CO 80204 ---- -- -- - - -- -- -
INSURER D:
INSURER E:
GUVERAGE5
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
LT
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE MMIDD/YY DATE MM/DD(YY)
LIMITS
A
GENERAL LIABILITY
34UUNEX2070
10/01/03
10/01/04
EACH OCCURRENCE
$1 000,000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE X OCCUR
FIRE DAMAGE (Anyone fire)
$300,000
MED EXP (Any one person)
$1 O OOO
PERSONAL &ADV INJURY
$1000000
X PD Ded:1,000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIM ITAPPLIES PER:
PRODUCTS -COMP/OP AGG_
$2,000,000
POLICY X JE/r LOC
A
AUTOMOBILE
LIABILITY
ANY AUTO
34UENEX2190
10/01/03
10/01/04
COMBINED SINGLE LIMIT
(Eaaccident) $1,000,000
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
X
HIRED AUTOS
NON -OWNED AUTOS
BODILY INJURY
(Per accident)
$
X
X
Drive Other Car
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
---
ANY AUTO
AUTOONLV: AGG
$
A
EXCESS LIABILITY 34XHUEX1980
X OCCUR El CLAIMS MADE
10/01/03
10/01/04
EACH OCCURRENCE
s2,0001000
$2,0001000
AGGREGATE
DEDUCTIBLE
X RETENTION $10000
$
B
WORKERS COMPENSATION AND
EMPLOYERS' LIA�:LI7Y
I618052
10/01/03
10/01/04
X WC ST MI_( OTH-
TORV LIMIT ER
E.L. EACH ACCIDENT i
_--
$500,000
E.L. DISEASE -EA EMPLOYEE s500,000
E.L. DISEASE -POLICY LIMIT $500,000
C OTHER Architects &
5397819
11/22/03
11/22/04
$2,000,000 per claim
Engineers
$4,000,000 annl aggr.
Professional Liab
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/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
nrnon ne c
SHOULD ANYOFTH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL30 DAYSWRITTEN
NOTICETOTHE CERTIFICATE HOLDERNAMEOTOTHE LEFT, BUTFAILURE TODOSOSHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURERJTS AGENTS OR
REPRESENTATIVE
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