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Home My WebLink AboutGE CONSTRUCTION INC - INSURANCE CERTIFICATEAC -RD, CERTIFICATE OF LIABILITY INSURANCE DATE PRODUCER (970)223-0924 FAX (970)267-2231 Colorado BW Insurance Agency, Inc Ol/30/2008/DD08 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1075 W Horsetooth Rd, Ste 106 Fort Collins CO 80526 HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW INSURED GE Construction, Inc P 0 BOX 177 Loveland CO 80539-0177 INSURERS AFFORDING COVERAGE INSURERA Addison Insurance Co NAIC # INSURER Pinnacol Assurance INSURER Evanston Insurance Co INSURER D nnvvs. n�.. INSURER E 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 INSURANCE POLICY NUMBER POLICY EFFECTIVE 09/06/2007 POLICY EXPIRATION MITS rGENERALLIABILITY ITY L GENERAL LIABILITY MADE O OCCVR 60073992 09/06/2008 EACH OCCURRENCE $ 1,000,000 DAMAGE TORENTD$ 1DD,DD $ 5 000 MED EXP (Any one person) PERSONAL & ADV INJURY $ 1,DOD,DDGENERAL AGGREGATE $ 2000 000 TEPLI IIT APPLIES PER LOC PRODUCTS COMP/OP AGO $ 2 000,00JECT AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS 60073992 09/06/2007 09/06/2008 COMBINED SINGLE LIMIT (Ee accident) $ 1 DDD ODD X SCHEDULED AUTOS HIRED AUTOS (PerBODILY on) $ X NON OWNED AUTOS BODILY (Per (Per eccidenq accident) $ X PROPERTY DAMAGE (Per ewdent) $ 25 ODD GARAGE LIABILITY AUTO ONLY EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC AUTO ONLY AGG $ $ A EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE 60073992 09/06/2007 09/06/2008 EACH OCCURRENCE $ 2 000 000 AGGREGATE $ DEDUCTIBLE X RETENTION $ 10,00 $ $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY 3352403 08/01/2007 68/01/2008 OTH tDISEASE NT $ 1 ODD, DD B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED' EMPLOYE $ 1,000,000 C If yes describe under SPECIAL PROVISIONS below OTHER xcess Umbrella Leased & Rented XOBW2274908 60073992 Ol 22 2008 / /$3,000,000 09/06/2007 09/06/2008 09/06/2008 LICY LIMIT $ 1 000 D00 $100 000 ui ment DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS The certificate holder is named as an Additional Insured with respect to the ongoing operations of the amed Insured on the General Liability only City of Fort Collins PO Box S80 Fort Collins CO 80522-0580 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 IN ER ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTA 1 1 ACORD 25 (2001/08) FAX (970)224-6134 Leslie 5 --s Wv Iwnn I wry 1400 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 endorsements) 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 BAG INSURANCE January 30, 2008 RE Certificate of Insurance for GE Construction, Inc To Whom It May Concern Please review the enclosed Certificate of Insurance carefully We are issuing revised certificates due to the following change in coverage Cancelled Excess Umbrella Liability, policy # 254085524 Effective 09/06/2007 to 01/22/2008 Replaced with Excess Umbrella Liability, policy # XOBW2274908 Effective 01/22/2008 to 09/06/2008 This change was made to better suit our client's needs If you have any questions or concerns please contact Dennis Shafer @ (970)267-2224 or Leslie Shade @ (970)267- 2225 Thank you, Leslie Shade Enclosure ( ohnadn BW Inewarce Agency Inc 1075 West Howetooth Road Sun, 106 Pon Collin CO 80526 (9-0) 2210924 (1) (970) 267 2211 (P)