HomeMy WebLinkAboutFCI CONSTRUCTORS - INSURANCE CERTIFICATE (6)ACORD,M CERTIFICATE
OF LIABILITY INSURANCE
O4/Oj//05D"Y'")
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Van Gilder Insurance Corp.
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
700 Broadway, Suite 1000
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver, CO 80203
303 837-8500
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER A: Zurich North America
FCI Constructors, Inc.
INSURER B: National Union Fire Ins. Co. (AIG)
PO Box 1767
INSURERc: Travelers Indemnity Company (CL)
Grand Junction, CO 81502
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.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MFFECTIY
POLICY EXPIRATION
DATE EXPIRATION
LIMITS
A
GENERALLIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE O OCCUR
GL0375709200
BLKT ADD'L
INSUREDS
BLKT WAIVER OF
SUBROGATION
04/01/04
10/01/05
EACH OCCURRENCE
$1000000
PRMAGE TO RENTED
$100 000
MED EXP (Any one person)
$1 O 000
PERSONAL S ADV INJURY
$1 00O 000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY X jECT LOC
PRODUCTS -COMPIOP AGG
$2000000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS, .
HIRED AUTOS
NON -OWNED AUTOS
BAP375709100
04/01/04
10/01/05
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per Person)
$ —_
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
B
EXCESSIUMBRELLA LIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
FxIRETENTION $ 10000
BE2911613
04/01105
10/01/05
EACH OCCURRENCE
$20 OOO OOO
AGGREGATE
s2000O 000
$
$
$
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICERIMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
WC375709000
04/01/04
10/01/05
TH-
X wOR I csTATU- I OPR
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA EMPLOYEE
$1,000,000
E.L. DISEASE -POLICY LIMIT
$1,000,000
C
OTHER Builders
Risk Reporting
Form
QT660142D8844TIL04
09/30/04
09/30/05
Max Value $20,000,000
Deductible $10,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
City of Fort Collins
Purchasing Division
215 N. Mason Street
Fort Collins, CO 80524
LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O_ DAYS WRITTEN
:E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
iE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
^ • l •' 1 1 we 1 R...'V VJVV
REPRESENTATIVE
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