HomeMy WebLinkAbout109256 BARKER CONSTRUCTION CO INC - INSURANCE CERTIFICATE (12)ACORD,. CERTIFICATE
OF LIABILITY INSURANCE
0DATE 9/07105DnYYY)
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
INSURERA: Zurich
Barker Construction Company, Inc
INSURER B: Pinnacol Assurance
142 North Timberline Road
Fort Collins, CO 80524
INSURER C:
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
IINSR
TYPE OF INSURANCE
POLICY NUMBER
PDATEYMWDD/YYEOLICYI
PDATE MMIDD/YY)
LIMITS
A
GENERAL LIABILITY
CP0375786002
05/01/05
05/01/06
EACH OCCURRENCE
$1 000 000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FXIOCCUR
DAMAGE TO RENTEDPREMISES (Ea n
a300 000
MED EXP(Any one person)
$10000
PERSONAL & ADV INJURY
$1 000 000
GENERAL AGGREGATE
s2000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$2 00O 000
x
1-1 POLICY PRO LOC
JECT
A
AUTOMOBILE
LIABILITY
ANYAUTO
CP0375786002
05/01/05
05/01/06
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
X
HIREDAUTOS
NON-OWNEDAUTOS
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
A
EXCESSIUMBRELLA LIABILITY
AUC375786102
05/01/05
05/01/06
EACH OCCURRENCE
$5000000
X1 OCCUR CLAIMS MADE
AGGREGATE
s5,000,000
$
DEDUCTIBLE
$
X RETENTION so
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIET&VI'ARTNER/EXEGUTIVE
4033353
10/01/05
10/01/06
X WC STATU- OTH-
Y IT ER
E.L. EACH ACCIDENT
s500,000
E.L. DISEASE - EA EMPLOYEE
$500,000
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
s500,000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
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 Department
PO 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 -10_ 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
Arnon ee/enn4 mo..---------
S
JU`n v r _vv vv..r v.v...v.. .a..
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
NVUmu zu- JLVU 1/V6) 2 012 #M325541