HomeMy WebLinkAbout254063 W L CONTRACTORS - INSURANCE CERTIFICATE (5). -A ORD,_ CERTIFICATE OF LIABILITY
INSURANCE
�2/29/200
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Lautenbach Insurance
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
5721 S. Nevada St.
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Littleton, CO 80120
P:303-798-2534 F:303-798-2536
INSURERS AFFORDING COVERAGE
INSURED
INSURERA: Auto -Owners Insurance CO.
W. L. Contractors, Inc.
INSURERB: American States Insurance
6435 W. 55th Ave.
INSURERC:
W.L. Job Number
INSURER D:
Arvada CO
F80002-
INSURER E:
GC
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 imwnD1YY1
POLICY EXPIRATION
DATE fMMIDDfYYI
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
® COMMERCIAL GENERAL LIABILITY
❑ CLAIMS MADE OCCUR
❑
004632-74117045
01-01-2004
01-01-2005
FIRE DAMAGE (Anyone fire)
$ 100,000
MED EXP (Any one Person)
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,000
®
$500. PD Decuctible
GENERAL AGGREGATE
$ 2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMP/OP AGG
$ 2,000,000
❑ ® POLICY PECiRO ❑ LOC
AUTOMOBILE
LIABILITY
ANY AUTO
LIMIT
OMBINED a accident)
(
$ 1, 000, 000
ED
BODILY INJURY
(Per Person)
$
A
ALL OWNED AUTOS
SCHEDULEDAUTOS
42-117-045-00
01-01-2004
01-01-2005
®
HIREDAUTOS
NON -OWNED AUTOS
BODILY INJURY
(Per accident)
$
®
❑
❑
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
❑ ANY AUTO
❑
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
A
EXCESS LIABILITY
® OCCUR Fr__11 CLAIMS MADE
❑ DEDUCTIBLE
® RETENTION $ 10,000
71684447
01-01-2004
01-01-2005
EACH OCCURRENCE
$ 8,000,000
AGGREGATE
$ 8,000,000
$
E
$
WORKERS COMPENSATION AND
WC STATU- OTH-
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
OTHER
H
Installation Floater
$500 Ded
01-CE-714402-04
01-01-2004
01-01-2005
Location 11000,000
Temp. &Transit 500,000
DESCRIPTION OF OPERATIONSA.00ATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Re: Annual Maintenance Contract
City of Ft. Collins
P O Box 580
Ft. Collins CO 80522-
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 030 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO
ITS AGENTS OR
ACORD
ACORD. CERTIFICATE OF LIABILITY INSURANCE
�2/E2(mg o
PRODUCER
Lautenbach Insurance
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
5721 S. Nevada St.
Littleton, CO 80120
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P:303-798-2534 F:303-798-2536
INSURERS AFFORDING COVERAGE
INSURED
W. L. Contractors, Inc.
6435 W. 55th Ave.
W.L. Job Number
INSURERA: Auto -Owners Insurance Co.
INSURERB: American States Insurance
INsuRERc:
INSURER D:
Arvada CO 80002-
NSURER E:
:UVtK
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 (MM/nDNY)
01-01-2004
POLICY EXPIRATION
DATE jMM1DD1YY1
LIMITS
A
GENERAL LIABILITY
® COMMERCIAL GENERAL LIABILITY
❑ CLAIMS MADE F OCCUR
❑
004632-74117045
01-01-2005
EACH OCCURRENCE
$ 11000,000
FIRE DAMAGE (Any one fire)
$ 100,000
MED EXP (Any one person)
$ 10,000
PERSONAL SADVINJURY
$ 11000,000
®
$500. PD Decuctible
GENERAL AGGREGATE
$ 2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
❑ POLICY ®] PRO ❑ LOC
PRODUCTS-COMP/OP AGG
$ 2,000,000
AUTOMOBILE
LIABILITY
ANY AUTO
(Ea sn.cBlNED iden�INGLE LIMIT
$ 1,000,000
A
ALL OWNED AUTOS
SCHEDULEDAUTOS
42-117-045-00
01-01-2004
01-01-2005
BODILY INJURY
(Per person)
$
lu
HIRED AUTOSBODILY
NON -OWNED AUTOS
INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
❑
'
GARAGE LIABILITY
❑ ANYAUTO
❑
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
A
EXCESS LIABILITY
® OCCUR O CLAIMSMADE
❑ DEDUCTIBLE
® RETENTION $ 10,000
71684447
01-01-2004
01-01-2005
EACH OCCURRENCE
$ 81000,000
AGGREGATE
$ 8,000,000
$
$
WORKERS COMPENSATION AND
WC STATUS OTH-
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
OTHER
B
Installation Floater
$500 Ded
01-CE-714402-04
01-01-2004
01-01-2005
Location 1,000,000
Temp. & Transit 500,000
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Re: Contractors License
CERT iFiCA l e HOLDEK I LJ I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
City of Ft. Collins
P O Box 580
Ft. Collins CO 80522-
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 030 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
ACORD 25S (7/97)