HomeMy WebLinkAbout113752 BT CONSTRUCTION - INSURANCE CERTIFICATE (10)ACORD. CERTIFICATE OF LIABILITY INSURANCE 10/01/2006 9/28/20051
DATE
PRODUCER Lockton Companies
P
8110 E Union Avenue
Suite 700
Denver CO 80237
(303)414-0000
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGEY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
INSURED
1047338 BT Construction, Inc.
9885 Emporia Street
Henderson, CO 80640
INSURER A: Travelers ro . Casualty
INSURER B: P. acol Assurance
INSURER
INSURER D
COVFRAGFA RT(()w01 VIT
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 I
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
1,000,000
FIRE DAMAGE (Any one fire
300,000
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE F X ] OCCUR
DTCO0605C71 SIND05
10/03/2005
10/03/2006
MED EXP (Any oneDemon)
5,000
PERSONAL & ADV INJURY
1,000,000
GENERAL A GREGATE
2,000,000
GEN'L AGGREGATE LIMIT APPLIES
PER:
PRODUCTS - COMP/OP AGG
2,000,000
Lt Y X JECT X
LO
A
AUTOMOBILE
LIABILITY
ANY AUTO
DT8100605C718TIL05
10/03/2005
10/03/2006
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
X
BODILY INJURY
(Per person)
$ XXXXXXX
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
$ XXXXXXX
X
X
HIREDAUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$ XXXXXXX
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$ XXXXXXX
OTHER THAN
AUTO ONLY:
XXXXXXX
ANY AUTO
NOT APPLICABLE
XXXXXXX
EXCESS LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
X OCCUR CLAIMS MADE
DTSMCUP0605C718TIL05
10/03/2005
10/03/2006
AGGREGATE
$ 1,000,000
XXXXXXX
O UMBRELLA
X}{XX}{XX
DEDUCTIBLE FORM
X XXXX
RETENTION
$
WORKERS COMPENSATION AND
4023016
10/01/2005
10/01/2006
TU-
}�' WCY tMIT OTH
$ 100,000
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOY
100.000
E.L. DISEASE - POLICY LIMIT
1 $ 500,000
OTHER
DESCRIPTION OF OPERATIONSILOCATONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
RE: City of Fort Collins Contract No. P951. City of Fort Collins is included as Additional Insured as respects General Liability.
2146488
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Fort Collins
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL U DAYS WRITTEN
Attn: Purchasing
215 North Mason St,
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Ft. Collins, CO 80524
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
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ACORD25-S171971 For questions rat;arding this cawtificate, conlact the number Noted In the 'Produwe section aiwva and speoify the client cotia -BTC0N6V- a)ACORDCORPORATIO 1988