HomeMy WebLinkAbout107125 BIVENS TRUCKING & EXCAVATING INC - INSURANCE CERTIFICATE (6)ACORD- CERTIFICATE OF LIABILITY
INSURANCE
PRODUCER
U4%291USD"YTY)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4821 Wheaton Drive
HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR
Y1 Box 270370
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
t Collins CO 80527
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
Barker Construction Company Inc
INSURERA Zurich
INSURERB Pinnacol Assurance
142 North Timberline Road
INSURER C
Fort Collins CO 80524
INSURER D
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
Imam
LTR
ADD'
NSR
TYPE OF INSURANCE
POLICY NUMBER
P LICY EFFECTIVE
DATE y
POLICY EXPIRATION
M
LIMITS
A
GENERAL LIABILITY
CP0375786003
05101/08
05/01/09
EACH OCCURRENCE
$1 QQQ QQQ
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 7 OCCUR
DAMAGE TO RENTEDPREMISE Ea mcurrencel_
$300 Q00
$1 Q 000
MED EXP (Any one person)
PERSONAL & ADV INJURY
$1 QQQ 000
GENERAL AGGREGATE
s2,000,000
GEN L AGGREGATE LIMIT APPLIES PER
PRODUCTS COMPIOPAGG
s2000000
POLICY X JEOT 7 LOC
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
CP0375786003
05/01108
05/01I09
COMBINED SINGLE LIMIT
(Ea accident)
$1 000 000
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Par person)
$
HIRED AUTOS
NON -OWNED AUTOS
X
BODILY INJURY
(Par accident)
$
X
PROPERTY DAMAGE
(Per acc dent)
$
GARAGE LIABILITY
AUTOONLY EAACCIDENT
$
OTHER THAN EA ACC
$
FAUTO
ANY AUTO
$
ONLY AGO
A
EXCESSIUMBRELLALIABILITY
X OCCUR CLAIMS MADE
AUC375786104
05/01/08
05101109
EACH OCCURRENCE
$2000000
AGGREGATE
$2 OOO OOO
DEDUCTIBLE
IS
X RETENTION $ 0
$
B
WORKERS COMPENSATION AND
4033353
10/01/07
10/01108
TATU OTH
X I TWORYSIER
MITEL
EMPLOYERS LIABILITY
EACH ACCIDENT
$1 QQQ QQQ
ANY PROPRIETOR/
EL DISEASE EA EMPLOYE
$1 000 000
If yeOFFIs EXCLUDED?
R/MEMBER E%CLUDEDi nder
E L DISEASE POLICY LIMIT
$1 QQQ QQQ
SPECIAL
SPECIAL PROVISIONS below
ALPRdescribe PROVISIONS
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Certificate holder is named as additional Insured but only as respects
liability arising out of work performed by the named Insured (Excluding
Workers Compensation) General liability coverage is primary and
non contributory
City of Fort Collins
Purchasing Department
PO Box 580
Ft Collins CO 80522
U) ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL '411_ DAYS WRITTEN
E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO 30 SHALL
IE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR
AU1H0R1ATVE
7C
H4VRV LO tLVV"1Ive) T Ot 2 #M413605 MAE 0 ACORD CORPORATION 1988