HomeMy WebLinkAbout166269 GARNEY CO - INSURANCE CERTIFICATE (15)this certificate is executed by Liberty Mutual Insurance Group as respects such insurance as is afforded by those companies. BM0068
Certificate of Insurance
This certificate is issued as a matter of information only and confers no rights upon you the certificate holder. This certificate is not an insurance policy and does not amend, extend, or alter the coverage
afforded by the policies listed below.
This is to certify that (Name and address of Insured)
GARNEY COMPANIES INC
1333 NW VIVION ROAD
KANSAS CITY, MO 64118
s, at the issue date of this certificate, insured by the Company under die policy(ieal bswd below. The insurance afforded by the listed policy(ies) is subject b
is not altered by any requirement, tam or
ExiDiration TvDe
Extended
Policy Term
AContinuous*
X
Workers Compensation
General Liability
HClaims Made
X Occurrence :1
Retro Date
Automobile Liability
X Owned
X Non-0wned
X Hired
10/01/2006
10/01/2006
10/01/2006
10/01/2006
atls�
all their terms, exclusions and conditions and
Limits of
WA2-14D-426942-735 I Coverage afforded under WC law of
WC2-141-426942-875 the following states:
AR, AZ, CO, FL, GA, KS, KY, MO, NE,
OK, SC, TN, TX, UT, WI, WY
Employers Liability
Bodily Injury By Accident
$1,000,000 Each Accident
Bodily Injury By Disease
$1,000,000 Policy Limit
Bodily Injury By Disease
$1,000,000 Each Person
TB2-141-426942-725 I General Aggregate -Other than Prod/Completed Operations
Products/Completed Operations Aggregate
Bodily Injury and Property Damage Liability I Per
Personal and Advertising Injury I Per Person /
Other Liability I Other Liability
XCU Included
ASI-141-426942-715 Each Accident - Single Limit - B. I. and P. D. Combined
Each Person
Each Accident or Occurrence
Each Accident or Occurrence
C *WA Policy includes deductible endorsement with $250,000 deductible per occurrence(claims (disease) with the provision that Liberty Mutual will (may) advance payment of
O the deductible amount. -- Project: Dry Creek Drainage Improvements - East Vine Box Culverts. City of Fort Collins (Owner) and URS Corporation (Engineer) are additional
M insured with respect to general liability where required by written contract.
M
E
N
T
-11 the cemticate expiration date is continuous or extended term, you will be notified if coverage is terminated or reduced before the certificate expiration date. However, you will not be notified annually of
the continuation of coverage.
Special Notice - Ohio: Any person who, with intent to defraud or knowing that he I she is facilitating a fraud against an insurer, submits an application a files a claim containing a false or
deceptive statement is guilty of insurance fraud.
Important information to Florida policyholders and certificate holders: in the event you have any questions or need information about this certificate for any reason, please contact your local sales producer,
whose name and telephone number appears in the Iowa left corner of this certificate. The appropriate local sales office mailing address may also be obtained by calling this number.
Notice of cancellation: (not applicable unless a number of days is entered below) . Before the stated expiration date the company will not cancel or reduce the insurance afforded under the above
policies until at least 60 days notice of such cancellation has been mailed to:
Office: OVERLAND PARK, KS Phone: 913-681-1700
Certificate Holder.
City of Fort Collins
300 LaPorte Avenue
Fort Collins, CO 80522
3
CYNTHIA HILL
Date Issued: 09/28/2005 Prepared By: CH