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113752 BT CONSTRUCTION - INSURANCE CERTIFICATE (13)
DATE(MWDDNY) ACORD,- CERTIFICATE OF LIABILITY INSURANCE 10/01/2004 1 09/22/2003 PRODUCER Lockton Companies THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION P ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 8110 E Union Avenue HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Suite 700 T PIES BELOW, Denver CO 60237 (303) 414-6000 INSURERS AFFORDING COVERAGE 4- INSURED INSURER A: St. Paul COT11 anies 1047338 BT Construction, Inc. 7801 Brighton Rd. INSURER e Commerce City, CO 80022 IN C : rnVPPAncc All 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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE IMM/DD1YYI POLICY EXPIRATION DATE (MWDDIYYI LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE [j] OCCUR KC08300152 10/03/2003 10/03/2004 EACH OCCURRENCE 1000 000 FIRE DAMAGE (Any one fire 300,000 MED EXP (Any oneperson) 5,000 PERSONAL & ADV INJURY 1,000,000 GENERAL AGGREGATE 1 2,000,000 GEN'L AGGREGATE LIMIT APPLIES POLICY X PRO- X PER: LOC PRODUCTS - COMP/OP AGG 2,000,000 A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS KC08300152 10/03/2003 - 10/03/2004 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ XXXXXXX X BODILY INJURY (Per accident) - $ XXXXXXX X PROPERTY DAMAGE (Per accident) $ XXXXXXX GARAGE LIABILITY ANY AUTO NOT APPLICABLE AUTO ONLY - EA ACCIDENT $ XXXXXXX OTHER THAN EA ACC AUTO ONLY: AGG XXXXXXX XXXXXXX A EXCESS LIABILITY X1 OCCUR CLAIMS MADE X UMBRELLA DEDUCTIBLE FORM RETENTION KC08300152 10/03/2003 10/03/2004 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 XXXXXXX XXXXXXX XXXXXXX B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 4023016 10/01/2003 10/01/2004 X 11TWnCRSTA, 12TH. E.L. EACH ACCIDENT 100 000 E.L. DISEASE- EA EMPLOYEE 100,000 E.L. DISEASE - POLICY LIMIT I $ 500 000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Re: Bid #5266, Boring Horizontal. r=OTICIr ATC unr nco 1 I . nwury r ATrnu 1874270 City of Fort Collins 256 W. Mountain SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN Fort Collins, CO 80521 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 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ' ACORD 25-S (7197) © ACORD CORPORATIOW1988