HomeMy WebLinkAboutFCI CONSTRUCTORS - INSURANCE CERTIFICATE (2)Client#: 14106 UVV tNAY rct
ACOP& CERTIFICATE OF LIABILITY INSURANCE 01/12/06 "'
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
WAUSAU SIGNATURE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
3430 OAKWOOD MALL DR - STE 300 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
EAU CLAIRE, WI 54701
DATE
aOn CERTIFICATE OF LIABILITY INSURANCE 0103/06 (MMIDDIYY)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Van Gilder Insurance Corp. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
700 Broadway, Suite 1000 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver, CO 80203
303 837-8500 � INSURERS AFFORDING COVERAGE
INsuREo INSURER A:Arch Insurance Group (Assurex Cap)
FCI Constructors, Inc. _ _ — _ -
INSURER B:National Union Fire Ins. Co. (AIG)
PO Box 1767 - -- - --
INSURERC:Hartford Insurance Group
Grand Junction, CO 81502 - -
INSURER D:
'OVERA
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 POLICYEFFECTIVE POLICY EXPIRATION
R TYPE OF INSURANCE POLICY NUMBER AT / 1 D!
LIMITS
A
�'i GENERAL LIABILITY ZAGLB9021900 10/01/05 1C 01106
EACH OCCURRENCE $1.r000 OOO
II X COMMERCIAL GENERAL LIABILITY
FIRE -DAMAGE (Any one fire)$, OO,000
CLAIMSMADEF X' OCCUR'il
D EXP (Any one person)) $10,000
-
PERSONAL A ADV INJURY ..$1,000000. _
GENERAL AGGREGATE ,$2,000,000
GEN'L AGGREGATE LIMIT APPL IESPER:
PRODUCTS COMPIOPAGG!.$2,000,000
PRO- LOC
POLICY
A AUTOMOBILE LIABILITY ZACAT9020600 110/01/05 ' 10101/06
i COMBINED SINGLE LIMIT I' $1,000,000
(Ea accident)
X ANY AUTO
ALL OWNED AUTOS
BODILY INJURY $
(Per person)
SCHE DULED AUTOS
X. HIRED AUTOS
BODILYINJURY $
X NON -OWNED AUTOS
(Peracc ident) -_
-
I PROPERTY DAMAGE $
1 (Per accident)
i_GARAGE LIABILITY -
AUTO ONLY-EAACCIDENT $
ANYAUTO
OTHERTHAN EAACC,$ -
_--. '.
AUTO ONLY: AGG $
B EXCESS LIABILITY �BE2911700 10101/05 10/01/06
i EACH OCCURRENCE s20,000,OOO
X OCCUR CLAIMS MADE'.
,-AGGREGATE _ $20,000,000 -
$
DEDUCTIBLE I�i
$
XRETENTION $10000
$
-
A ,WORKERS COMPENSATION AND iZAWC19056200 1OI01/O5 10/07/06
X_-WCSTATUS ER
TORY LIMITS_ER _
EMPLOYERS' LIABILITYI, !
E.L. EACH ACCIDENT :.$1,000,000
E.L.DISEASE-EA EMPLOYEE' $1,000,000
E.L.DISEASE-POLICY LIMIT $1,000,000
C OTHER Leased/ 34UUMAK6935 10/01/05 10/01/06
1 $200,000 Max Value
Rented Equipment i
$2,500 Deductible
DESCRIPTION OF OPERATIONS(LOCATIONS/VEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
CANCELS AND REPLACES ANY PREVIOUSLY ISSUED CERTIFICATE FOR THE 2005-2006 POLICY TERM.
SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
r AT=TW1=0=nC TMFICC1111J911JC11RFR Wl I I FNDFAVDRTn MAII in nAYSWRITTFN
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.
ACORD 25S (2001108) 2 of 3 #M396612
DESCRIPTIONS (Continued from Page 1) 1
LIABILITY POLICY PER GLO566 AND AS LIMITED INSURED UNDER THE AUTO PER
CA2048.
AMS 25.3 (2001/08) 3 of 3 #M396612