HomeMy WebLinkAboutBEMAS CONSTRUCTION - INSURANCE CERTIFICATE (2)A- CORD. CERTIFICATE OF LIABILITY INSURANCE DATE1o/o/oe
8/08 YY)
PRODUCER 1-303-511-4517 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
IMA of Colorado, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1550 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Suite 00 600 1street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Suit
Denver, Co 80202 INSURERS AFFORDING COVERAGE
INSURED
Bemas Construction, Inc.
80 Inverness Drive East
Englewood, CO 80112-5114
River
Insurance
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.
SR.m
IN
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
09/30/08
POLICY EXPIRATION
LIMITS
A
GENERAL LIABILITY
FMMA0014302
09/30/09
EACH OCCURRENCE
$ 1, 000, 000
X COMMERCIAL GENERAL LIABILITY
FIRE DAMAGE (Anyone fire)
$50,000
MED EXP (Any one person)
$ 0
CLAIMS MADE F-xl OCCUR
X FD Ded:$10,000
PERSONAL &ACV INJURY
$ 1, 000, 000
_—
GENERAL AGGREGATE
$2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
11 POLICY X PRO- LOG
PRODUCTS - COMP/OP AGO
$2,000,000
B
AUTO
X
MOBILE LIABILITY
ANY AUTO
34UENIQ7601
09/30/08
09/30/09
COMBINED SINGLE LIMIT
(Ea accident)
$ 1, 000, 000
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per person)
$
X
HIRED AUTOS
NON -OWNED AUTOS
BODILY INJURY
(Per accident)
$
X
PROPERTYDAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OATTHOR THAN EA ACC
$
ANY AUTO
$
OLYUN: AGO
C
EXCESS LIABILITY
X OCCUR CLAIMS MADE
000190462
09/30/08
09/30/09
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$ 1,000,000
$
$
DEDUCTIBLE
RETENTION $0
$
D
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
4032634
10/01/08
10/O1/09
X WC STATU OTH
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE - EA EMPLOYEE
$500,000
E.L. DISEASE -POLICY LIMIT
$500,000
OTHER
5
S
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Fort Collins 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
PO Box 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
Fort Collins, CO 80522-0580 AUTHORIZED REPRESENTATIVE S
USA [/
ACORD 25-S (7/97) tdentt O 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.