HomeMy WebLinkAbout113752 BT CONSTRUCTION - INSURANCE CERTIFICATE (11)AMR& CERTIFICATE OF LIABILITY INSURANCE to/ol/2o06 06/29/ Arnow61
PRODUCER Lockton Companies
P
8110 E Union Avenue
Suite 700
Denver CO 4-6000 80237
(303) 414-
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 COVERAGE AFFORDEDTHE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
INSURED
1047338 BT Construction, Inc.
Attn: Michelle Ciancio
9885 Emporia Street
Henderson, CO 80640
INSURER A: Travelers ProCasualty
INSURER B : P' acol Assurance
INSURER C :
INSURER D'
THIS
COVERAGES BTCON01 VUINSURERiS).
ERT URAPD ET NOT CONSTITUTE A DC
ODURANCERTIFICATE
E
HDER
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
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE IMMIDDfYYI
POLICY EXPIRATION
DATE MMfDDIYY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE [K OCCUR
DTC00605C718IND05
10/03/2005
10/03/2006
EACH OCCURRENCE
$
1,000,000
FIRE DAMAGE (Any one fire
$
300,000
MED EXP (Any oneperson)
$
$ 000
PERSONAL a ADV INJURY
$
1,000,000
GENERAL AGGREGATE
$
2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY X JECT X LOC
PRODUCTS - COMP/OP AGG
$
2,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
DT810060$C718TIL05
2
yy
` 7 �� 4
ITY OF FUk
RISK MANAGEMENT
-
/000MBINED
7
2006
I�ULLINS
SINGLE LIMIT
(Ea accident)
$
1,000,000
X
BODILY per INJURY
person)
(Per on)
S
XX? XXX
X
BODILY INJURY
(Per accident)
S
XXXXXXX
X
PROPERTY DAMAGE
(Per accident)
s
�
xxRxx
GARAGE LIABILITY
ANY AUTO
NOT APPLICABLE
AUTO ONLY - EA ACCIDENT
$
XXXXXXX
OTHER THAN EA ACC
AUTO ONLY: AGG
$
XXXXXXX
$
XXXY—VM
A
EXCESS LIABILITY
X OCCUR CLAIMS MADE
X UMBRELLA
DEDUCTIBLE FORM
RETENTION S
DTSMCUP0605C718TIL05
10/03/2005
10/03/2006
EACH OCCURRENCE
$
1,000,000
AGGREGATE
$
1,000,000
$
XXXXXXX
X'}{X'){XXx
$
XXXXXXX
B
WORKERS COMPENSATION AND
EMPLOYERS•LULBILITY
4023016
10/01/2005
10/01/2006
X W STATU- O H-
E.L. EACH ACCIDENT
$
100,000
E.L. DISEASE - EA EMPLOYEO
$
100.000
E.L. DISEASE - POLICY LIMIT
1 $
500,000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
RE: Bobcat Ridge Access Larimer County Road 32C Improvements. The City of Fort Collins and Anderson Consulting Engineers are included as Additional
Insureds with respects to General Liability.
PCOTICIPATC unI nets
I X
I.r1.1"nUA1 m¢uecn.,u.ueco,ctrco.
PAKI `Cl I ATInM
2610151
City of Fort Collins
P.O. Box 580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3_ DAYS WRITTEN
Fort Collins, CO 80522
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,SUT FAILURE TO DO SO SHALL
-
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25-3 (7197) F«qu. Uonsreg"nattd.e.raftc.,.ontn*fiwn.mb.ra.t.d)ntn.'Prod.c*e..ctiw , w.ndso cure».e.ntcod.TTcomm" ®ACORD CORPbRAT10N 1988