HomeMy WebLinkAboutBEMAS CONSTRUCTION - INSURANCE CERTIFICATE (3)QoulArnM
ACtog . CERTIFICATE OF LIABILITY INSURANCE
DATE
08129/060nr)
PRODUCER
IMA of Colorado, Inc.
1550 17th Street, Suite 600
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
Denver, CO 80202
303 534-4567
INSURED
INSURER A: Pinnacol Assurance
Barnes Construction, Inc.
INSURER B:
80 Inverness Drive East
Englewood, CO 80112-5114
INSURER C:
INSURER D:
INSURER E:
ArE*
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.
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICYEFFECTIVE
DATE IMMIDDIYYI
POLICY EXPIRATION
DATE IMMIDDIYY)
LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
EACH OCCURRENCE
$
FIRE DAMAGE (Anyone flre)
_
$
MED EXP (Any one person)
$
PERSONAL S ADV INJURY
$
GENERAL AGGREGATE
$
GEN'L AGGREGATE LIMITAPPLIES PER:
POLICY PRO LOC
JECT
PRODUCTS -COMP/OPAGG
$
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
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
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
EXCESS LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE_
$
AGGREGATE
$
$
$
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
4032634
09/01/06
09/01/07
X we srATu- OTH-
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE -EA EMPLOYEE
$500,000
E.L. DISEASE -POLICY LIMIT
1 $500,000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
City of Fort Collins
PO Box 580
Fort Collins, CO 80522-0580
SHOULD ANYOFTHEABOVE DESCRIBED POLX:ESBE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL3D—DAYSWRI7TEN
NOTICE TOTHE CERTIFICATE HOLDERNAM ED TOTHE LEFT, BUT FAILURE TODOSO SHALL
IM POSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TH E INSURER,ITS AGENTS OR
REPRESENTATIVE
ACUKU ZO-s plaT)1 of 2 #M311096 VPS 0 AcuKU cUKrUKAITUN Tana
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 z5-S (N97)2 of 2 #M311096