HomeMy WebLinkAbout254063 W L CONTRACTORS - INSURANCE CERTIFICATE (2)ACORD,M CERTIFICATE OF LIABILITY INSURANCE
DATF. IMMIDDII9'YYI
4/28/2008
PRODUCER (303)798-2534 FAX: (303)798-2536
Lautenbach Insurance Agency, LLC
g Y�
5721 S. Nevada St.
Littleton 80120
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 #
_ _CO
INSURED
W.L. Contractors, Inc.
5920 Lamar St.
Arvada CO 80003
INSURER A: Mountain States Ins.
_
INSURER B: Pinnacol Assurance
_
INSURERC Safeco Insurance Co.
INGUR[R D'.
INSURER
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TI IF INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO 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 DFSCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
A I ' lEjjMLU-SBQWN MAY HAVE-RE-N REDUCED BY PAID CLAIM
INSR
'L
ADDtn
TPEOFINSURANCE
POLICY NUMBER
POLICY EFFECTIVE
P DAITEMMIODA( ON
LIMITS
A
GENERAL LIABILITY
X f,OMMBRCIAI. GENERAL LIABILITY
CLAIMS MADE ElOCCURCPP0098006
X Contractual Liab
5/1/2008
5/l/2009
EACH C RRF.N F.
S 1,000,000
DAMAGE TO
DEa Smo roncos
100,000
MED EXP (Any one .,son
$ 10,000
PERSONAL BAOV INJURY
s 1,000,000
GENERAL AGGREGATE
a 2,000,000
GEN'L AGGREEGAI
POLICY
E LIMIT APPLIES PER:
PR T LOC
FRI
PROD , COMPICPA(G
S 2,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNFO AUTOS
BAP0098006
5/1/2008
5/1/2009
COMBINED SINGLE LIMIT
(Ee..,dent)
S 1, 000, 000
X
BODILY INJURY
(Per person)
X
X
BODILY INJURY
(Per accaenp
S
PROPERTY DAMAGE
(Pcr accident)
_
_
GARAGE LIABILITY
ANYAUTO
AUTO ONLY- EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY AGO
S
$
A
EXCESSIUMBRELLA LIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION S 10,000
U]AB0098006
5/1/2008
5/1/2009
0�91iBENCE_5
5,000,006
AGGREGATE
$ 5,000,000
_
e
_
t
a
WORKERS COMPENSATION AND
GMPLOYCRS' LIABILITY
ANY PROPRIETORlPARTNERAIXECUTIVE
OFRCERIMEMBER EXCLUDED'
I/ yes, describe under
SPECIAL PROVISIONS bsIow
2327630
l/l/2008
1/1/2009
X WC TATTLIM - I OT�H2-
EL EACH ACCIDENT
S 1,000,000
EL. DISf.A$E-EAEMPLOYEES
1, 000,000
EL. DISEASE � POLICY LIMIT
IS 110001000
("
OTHER Installation Floater
01-CE-717347
l/1/2008
1/1/2009
Location $1,000,000
De1'emp & Transit $500,000
DESCRIPTION OF OPERATIONSILOCATIONSWEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Certificate Holder is Additional. Insured.
Re: Contractors License
City of Ft. Collins
Engineering Department
P O Sox 580
Ft. Collins, CO 80522
SHOULD ANY OF THE ABOVE OESCRIBED 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 DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Cre(}' I.auCenbaCh/HATE
Irnan 9c nnm in -Al -- -- ---
INS025 fotom ooa
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