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HomeMy WebLinkAboutSINNETT BUILDERS - INSURANCE CERTIFICATE (8)ACORD- CERTIFICATE OF LIABILITY INSURANCE 1 0DATE 6/25/03D PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4821 Wheaton Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O Box 270370 Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Travelers Insurance Sinnott Builders, Inc. INSURERB: Pinnacol Assurance P.O. Box 1969 INSURERc: Fireman's Fund Insurance, Co. Fort Collins, CO 80522 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 pgTEYMMIDDIYYE PDATE MMIDD TION LIMITS A GENERAL LIABILITY CO283N6279IND03 06/30/03 06/30/04 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY DAMAGES (Ea occurrerice) RENTED $300000 CLAIMS MADE 51 OCCUR MED EXP (Any one person) $$ 000 PERSONAL & ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2000000 RO POLICY X jECT LOC A AUTOMOBILE LIABILITY ANY AUTO/�CI 810283N6279TIL03 O6/30/03 �l�/ 6/ 4 4 A d� MBINED SINGLE LIMIT accident) $1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULEDAUTOS HIRED AUTOS NON -OWNED AUTOS Drive Other Car JUN C� 1 Y UV M 21 2d93 U� A I FN N]�iJ� X BODILY INJURY er accident) $ X X PROPERTY DAMAGE (Peraccident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG A EXCESS/UMBRELLALIABILITY CUP283N6279TIL03 06/30/03 06/30/04 EACH OCCURRENCE $5000000 X OCCUR CLAIMS MADE AGGREGATE s5,000,000 s $ DEDUCTIBLE 1XI $ RETENTION $ 10000 B WORKERS COMPENSATION AND 4045474 07/01/03 07/01/04 X WC STAru- OTH- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $500 000 E.L. DISEASE - EA EMPLOYE s500,000 OyFFICER/MEMBER EXCLUDED? SIf Pesdescribe under ECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $500,000 C OTHER MX198380752 06/30/03 06/30/04 $6,000,000 Limit Builders Risk $2,500,000 Frame Limit $ 1,000 Deductible DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Re: Homestead Park; Bid No. 5723 Certificate holder is named as additional insured, but only as respects liability arising out of work performed by the named insured (Excluding Workers' Compensation). Waiver of Subrogation applies to Workers' Compensation only. City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _ In DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL NO OBLIGATION OR LIABILITY OF KIND UPON THE INSURER, ITS AGENTS OR ACORD 25 (2001/08) 1 of 2 #M251403 AUTHORIZED © ACORD CORPORA Client#: 20369 SINBU ACORD- CERTIFICATE OF LIABILITY INSURANCE °�""' 06125/0 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Insurance Inc 4821 Wheaton Drive ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O Box 270370 Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: Travelers Insurance Sinnott Builders, Inc. P.O. Box 1969 Fort Collins, CO 80522 INSURERS: Pinnacol Assurance INSURERc: Fireman's Fund Insurance, Co. 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 MMIDD POLICY EXPIRATION DATE MM/DDIYY LIMITS A GENERAL LIABILITY CO283N62791ND03 06/30/03 06/30/04 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDPREMISES fEa occurrence) a300 000 CLAIMS MADE O OCCUR MED EXP (Any one person) $5 000 PERSONAL & ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 RO- LOC POLICY X j ECT A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS 810283N6279TIL03 06/30/03 q1---1yrrJ��I�--•II \ /%'�' N . ��"' (\�I\y/-•�.,SIJ. 06/30/04 ;.-h--4 9`Pa 1)tl(3�/1) )1 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ X INJURY (Paccden) (Per accident) $ HIRED AUTOS NON -OWNED AUTOS 2 (1 Q X X PROPERTY (Per accidentDAMAGE $ Drive Other Car ORT O� iNS GARAGE LIABILITY R SlK M.P.N AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTOONLY: AGG A EXCESSIUMBRELLA LIABILITY CUP283N6279TIL03 06/30/03 06/30/04 EACH OCCURRENCE $5 000 000 X OCCUR CLAIMS MADE AGGREGATE $5 000 000 $ RDEDUCTIBLE - $ X RETENTION $ 10000 1 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE 4045474 07/01/03 07/01/04 WC STATUS OTH- X I ER E.L. EACH ACCIDENT $500000 E.L. DISEASE - EA EMPLOYEE $500,000 OFFICER/MEMBER EXCLUDED? If Ses n PECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $500,000 C OTHER MX198380752 06/30/03 06/30/04 $6,000,000 Limit Builders Risk $2,500,000 Frame Limit $ 1,000 Deductible DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE: Meter Shop Building Certificate holder is named as additional insured, but only as respects liability arising out of work performed by the named insured (Excluding Workers' Compensation). General Liability coverage is Primary and Non-contributory. City of Fort Collins Purchasing & Risk Management PO Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL -In DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LUIBIL)PFOE,eNY KIND UPON THE INSURER, ITS AGENTS OR AUTHORRED