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Home My WebLink About168787 GOLDEN TRIANGLE CONSTRUCTION INC - INSURANCE CERTIFICATE (9)Client#: 51920 8GOLDTRI1 ACORD., CERTIFICATE OF LIABILITY INSURANCE DATE 09/02/080nvvv) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HRH of Colorado ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 720 South Colorado Boulevard HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 60ON Denver, CO 80246 INSURERS AFFORDING COVERAGE NAIC # INSURED Golden Triangle Construction, Inc. 700 Weaver Park Rd. Longmont, CO 80501 INSURER A. CNA Insurance Companies B6486 INSURER B: Pinnacol Assurance 41190 INSURER C: OneBeacon American Insurance Compan t 20621 --"-' INSURER D: INSURER E: COVERAGES 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 LTR 4OD-1. INSRt TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD POLICY EXPIRATION DATE MMIDD/YY LIMITS A GENERAL LIABILITY TCP2022866738 12/31/07 12/31/08 EACH OCCURRENCE $1000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $500OOO CLAIMS MADE 51OCCUR MED EXP (Any one person) $5 000_,__ PERSONAL &ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2000000 POLICY X PFCT RO- X LOC A AUTOMOBILE LIABILITY ANY AUTO C2022866741 12/31/07 12/31/08 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIREDAUTOS NON -OWNED AUTOS X PROPERTY DAMAGE (Peraccidenp $ Physical Damage ACV less Ded GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHERTHAN EA ACC $ ANY AUTO $ AUTO ONLY: AGO A EXCESSIUMBRELLA X LIABILITY OCCUR CLAIMS MADE CUP2022866786 12131/07 12131/08 EACH OCCURRENCE $7000,000 AGGREGATE s7,000,000 5 $ DEDUCTIBLE X $ RETENTION $ 1 O 000 B WORKERS COMPENSATION AND 4013024 10/01/08 10/01/09 X WC STIAMTU- OTH- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $1 OOO,OOO E.L. DISEASE- EA EMPLOYEE $1 000000 OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 C OTHER Leased &tor 790005057 01/01/08 12/31/08 $100,000less Ded Rented Equipment Owned Equipment ACV less Ded DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS This Certificate of Insurance represents coverage currently in effect and may or may not be in compliance with any written contract. * The following cancellation conditions always apply: (See Attached Descriptions) City of Ft. Collins 215 N. Mason PO Box 580 Fort Collins, CO 80524 LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL *3111 DAYS WRITTEN E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL tE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHO IZED REPRESENTATIVE Cp- J ACORD 25 (2001108) 1 of 3 #M601702 8CMAR 0 ACORD CORPORATION 1988 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 (2001/08) 2 of 3 #M601702 DESCRIPTIONS (Continued from Page 1) • 10 days for non-payment of premium -If policy shown, 10 days for Workers' Compensation for fraud; material misrepresentation; non-payment of premium; other reasons approved by the Commissioner of Insurance AMS 25.3 (2001/08) 3 of 3 #M601702