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Home My WebLink AboutCLARK CONSTRUCTION CO - INSURANCE CERTIFICATEr Le.,Fu o�nna ACORD, CERTIFICATE OF LIABILITY GLAGO INSURANCE DATE(m/0m8 YVV) PRODUCER O2/29/OS Flood & Peterson Insurance Inc THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4821 Wheaton Drive HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR P 0 Box 270370 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Fort Collins CO 80527 INSURERS AFFORDING COVERAGE NAIC # INSURED Clark Construction Co Inc INSURERA Travelers Insurance Company INSURER B Pmnacol Assurance 2956 Glnnala Drive INSURER Loveland CO 80538 INSURER D INSURER E cnuooer_ee 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 MMIDDNV POLICY EXPIRATION DATE IMMIDD[YYJ LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE Dx� OCCUR PD Ded 2,500 DTCO283P245A 03/01/08 03/01/09 EACH OCCURRENCE $1 QQQ QQQ X DAMAGE TO RENTED $300 QQQ MED EXP (Any one person) $j QQQ X PERSONAL & ADV INJURY $1 QQQ 000 GENERAL AGGREGATE s2,000,000 GEN L AGGREGATE LIMIT APPLIES PER POLICY F X1 jEO 7 LOC PRODUCTS COMP/OP AGG $2 OOQ OOO A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNEDAUTOS SCHEDULED AUTOS HIRED AUTOS NON-0WNEDAUTOS DT810283P245ATIL08 03/01/08 03/01/09 COMBINED SINGLE LIMIT (Ea accident) $1 000 000 BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ A GARAGE LIABILITY ANY AUTO EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMS MADE DEDUCTIBLE X RETENTION $1 OOOO DTSMCUP283P245ATIL 03/01/08 03/01/09 AUTO ONLY EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY AGG EACH OCCURRENCE $ $ $1000000 AGGREGATE $1 QQQ 000 B AND EMPLOYERS MPLOYWORKERS LIABILITY EMP PRORSLIABILITY ANY PROPRIETOR/ EXCLUDED? OFFICER/MEMBER EXCLUDED? If yes describe under SPECIAL PROVISIONS below OTHER 4000003 4000003 O4/01/07 04/01/08 O4/01/08 04/01/09 X WC STATU OTH EL EACH ACCIDENT $500000 E L DISEASE EA EMPLOYE $500 QQQ E L DISEASE POLICY LIMIT $500 QQQ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Per Project Aggregate if per agreement Prior to Loss r FIQTIFIr ATF Mn1 nvn _ City of Fort Collins P O Box 580 Fort Collins CO 80522 I ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION HEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL NO OBLIGATION OR LIABILITY OF ANY HIND UPON THE INSURER ITS AGENTS OR AUTHORIZED REPRESENTATIVE y- F%OOiOR 'r, 'RAdfJio11 iAJf✓/'IH.R/GR , Z JC 25 (2001/08) 1 of 2 #M407722 MAE 0 ACORD CORPORATION 1989 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 25-S (2001/oa) 2 of 2 SMdn7799