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HomeMy WebLinkAboutBRB CONTRACTORS - INSURANCE CERTIFICATE (5)ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID DATE (MMIDDIYYYY) BRBCO01 03 30 06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Cretcher-Lynch & Co. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 8511 Hillcrest Road, Suite 300 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Kansas City MO 64138-2777 Phone:816-444-9494 Fax:816-444-5474 INSURERS AFFORDING COVERAGE NAIC# IN5UREU INSURER A: Travelers Property Casualty INSURER B: Steadfast Insurance Co. BRB Contractors, Inc. INSURER C: 3805 NW 25th Street INSURER D: Topeka KS 66618 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 NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDDIYY POLICY EXPIRATION DATE MMIDDIYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR EACH OCCURRENCE $ PREMISES (Ea occurence) $ MED EXP (Any one person) $ PERSONAL& ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PROJECT LOC PRODUCTS - COMP/OP AGG $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULEDAUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHERTHAN EA ACC AUTO ONLY: AGG $ $ B EXCESSIUMBRELLA LIABILITY OCCUR CLAIMSMADE DEDUCTIBLE X RETENTION $ 10 , 000 AUC591934400 04/01/06 04/01/07 EACH OCCURRENCE $ 10,000,000 AGGREGATE $10,000,000 $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If es, describe under SPECIAL PROVISIONS below TORY LIMITS I ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEEI $ E.L. DISEASE - POLICY LIMIT $ A A OTHER Builders Risk lBoiler & Machinery QT6307644B708 IQT6307644B708 04/01/06 1 04/01/06 04/01/07 1 04/01/07 Coverage See Below 1 Ded 10 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION ONE IL21 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION James O'Neill, CPPO, FNIGP DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN City of Fort Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Director Purchasing & Risk Mgt 215 North Mason St., 2nd Floor IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Fort Collins CO 80524 REPRESENTATIVES. AUT► ORIJDf,F�'RESENTATIVE ACORD 25 (2001/08) © ACORD CORPORATION 1988 'his certificate is executed by Liberty Mutual Insurance Group as respects such insurance as is afforded by those companies. BMU068 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) BRB CONTRACTORS INC. 3805 NW 25TH STREET PO BOX 750940 TOPEKA, KS 66618 is not altered by am, requirement, term or ExPiration Type Continuous* Extended Policy Term JX Workers Compensation General Liability HClaims Made X Occurrence Retro Date Automobile Liability X Owned X Non -Owned X Hired W E N T 04/01/2007 04/01/2007 04/01/2007 Fro` + )licy(ies) listed below. The insurance afforded by the listed policy(ies) is subject to all their terms, exclusions and conditions and r document with respect to which this certificate ma be issued. Policy Numbers Limits of Liabili WC2-141-433275-016 Coverage afforded under WC law of Employers Liability the following states: Bodily Injury By Accident AR, CO, IA, KS, MN, MO, ND, NE, NM, $1,000,000 Each Accident OH, OK, SO, TX Bodily Injury By Disease $1,000,000 Policy Limit Bodily Injury By Disease $1,000,000 Each Person TB2-141-433275-026 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 Other Liability $100,000 Fire Legal $10,000 Medical AS2-141433275-036 Each Accident - Single Limit - B. I. and P. D. Combined Each Person Each Accident or Occurrence Each Accident or Occurrence -it me certiicate expiration date is continuous or extended term, you will be notuied it coverage is terminated or reduced betore the cermllcate expnanon date. However, you will not be not1t1W annually of the continuation of coverage. Special Notice - Ohio: Any person who, with intent to defraud or knowing that he / she is facilitating a fraud against an insurer, submits an application or 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 lower 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 30 days notice of such cancellation has been mailed to: Office: OVERLAND PARK, KS Phone: 913-681-1700 Certificate Holder. City of Fort Collins Attn: James O'Neill, Director, Purchasing & Risk Mgmt 215 North Mason Street, 2nd Floor Fort Collins, CO 80524 CHRISTINA GRAVELY Date Issued: 03/28/2006 Prepared By: CH