HomeMy WebLinkAboutRKL CONSTRUCTION - INSURANCE CERTIFICATE (2)ACORDM CERTIFICATE OF LIABILITY INSURANCE
02/03/Z 0 '
P ODUCER (303) 756-9909 FAX (303) 756-8818
'Keller -Lowry Insurance Inc
1777 S Harrison St #700
Denver, CO 80210
Teresa Heupel
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 AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED RKL Construction Corporation
6500 Stapleton Dr So. D-12
Denver, CO 80216
INSURERA: Bituminous Insurance
INSURERS: Pinnacol Assurance
INSURER C:
INSURER D:
INSURER E:
rnVFRA[.FR
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
ADD'L
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE IMMIDDIYY)
POLICY EXPIRATION
DATE fMM1DD1YYI
LIMITS
GENERAL LIABILITY
CLP3171022
08/04/2004
08/04/200S
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
$ 100,000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE Fil OCCUR
MED EXP (Any one person)
$ 5,000
A
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000,000
X POLICY PROJECT LOC
AUTOMOBILE
LIABILITY
ANY AUTO
CAP3171023
08/04/2004
08/04/2005
COMBINED SINGLE LIMIT
(Ea accident)
$
1,000,00
X
A
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHERTHAN EAACC
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESSIUMBRELLA LIABILITY
CUP2S7202S
08/04/2004
08/04/2005
EACH OCCURRENCE
$ 5,000,00
X OCCUR ❑ CLAIMS MADE
AGGREGATE
$ 5 , 000 , OO
A
$
$
FDEDUCTIBLE
X RETENTION $ 10, 00
$
WORKERS COMPENSATION AND
4004154
08/01/2004
08/01/200S
X I WC sTATU- I X I OTH-
TORY LIMITS ER_
B
EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, deunder
SPECIALscribe PROVISIONS below
EACH ACCIDENT E.L.$
1,000,000
E.L. DISEASE - EA EMPLOYE1
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
1 $ 1,000,00
A
OTHER
Leased & Rented
Equipment
CLP3171022
08/04/2004
08/04/2005
$2S,000 Max Limit Per Item
$50,000 Aggregate Limit
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS
The City of Fort Collins is additional insured as their interest may appear with regard to
general liability.
City of Fort Collins
Att: Engineering Department
P 0 Box 580
Fort Collins, CO 80522-OS60
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE /7 _
ACORD 25 (2001108) OACORD CORPORATION 1988
kkic
avSUanniCE
CONTINUATION CERTIFICATE
## Duplicate Copy ##
TO: KELLER-LOWRY INSURANCE, INC.
1777 SOUTH HARRISON #700
DENVER, CO 80210
Denver
5300 DTC Parkway #490
Greenwood Village, CO 80111
(303) 224-0477
(888) 316-2242
(303) 224-0476 FAX
RKL-CONSTRUCTION-CORPORATION
as Principal, and Contractors Bonding and Insurance Company, a Washington corporation, as Surety, hereby
notify:
CITY OF FORT COLLINS
as Obligee, that the above named Principal's bond number KA1086 in the amount of $20,000
shall be continued in force effective 02-MAR-06 and shall remain in full force and effect until the soonest of
(1) 02-MAR-07 , (2) it is cancelled by the surety, or (3) it is otherwise terminated.
The aggregate liability of the surety shall not exceed the amount of this certificate. The liability of the surety shall
not cumulate by reason of this certificate, any future continuation certificate, any change rider, endorsement,
modification, new bond, reinstatement, reissue, renewal, replacement, substitution or any other extension of
suretyship.
IF THIS BOND IS REQUIRED TO BE FILED WITH ANY AGENCY, THIS CERTIFICATE SHALL BE
VOID IF THE PRINCIPAL DOES NOT FILE THIS CERTIFICATE WITH THE REQUIRED AGENCY
*ITHIN THIRTY (30) DAYS OF THE EFFECTIVE DATE OF THIS CERTIFICATE ---
IN WITNESS OF THIS CONTRACT, the Principal and the Surety have affixed their hands and seals this 6TH
day of MARCH 2O06
Principal: RKL CONSTRUCTION CORPORATION
By. _,__...,.,.,,,
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Surety: Contractors Bonding and Insurance Company
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