HomeMy WebLinkAbout113752 BT CONSTRUCTION - INSURANCE CERTIFICATE (8)ACORD. CERTIFICATE OF LIABILITY INSURANCE 10/1/2009 7
MIDDNYYY
DA 9/23/2008 )
PRODUCER Lockton Companies, LLC Denver
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
8110 A Union Avenue
Suite 700
Denver 80237
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
-
(303) 414-6000
INSURERS AFFORDING COVERAGE
NAIC #
INSURED 13T Constriction, Inc.
INSURER A: Travelers Prop.CasuaY
Casualty
9$85 Bmpo[ld Street
_.._._.._.
INSURER B: PIppAC01 ASSDraDOB
I lenderson, CO 80640
—..._....__._..
INSURER C:
INSURER _..........._...............
D:
NSURER E:
COVERAGES BTCONOI VU
SIURER S) NOR¢ED REPRESENTATIVEOR DO ES NOT CO PRODU ER AND HE
CERTIFICATE EEN HOLiDER.NG
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.
INSft
LTR
ADD1
NSRC
TYPE OF INSURANCE
POLICY NUMBER
POLICYEFFECTIVE
DATE MMOD/YT'
POLICYEXPIRATION
DATE MMIDD/YY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
1000000
DAMAGETDREED
PREMISES Ea occNTuranca
_
$
300,000
A
X COMMERCIAL GENERAL LIABILITY
DTC00605C7181ND08
10/3/2008
10/3/2009
CLAIMS MADE Q OCCUR
MED EXP (Any one person)
$
5,000
PERSONAL B ADV INJURY
$
1,000,000
GENERAL AGGREGATE
$
2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OPAGG
$
2,000,000
POLICY X PRO- X LOC
ECT
A
AUTOMOBILE LIABILITY
X ANY AUTO
DT8100605C718TIL08
10/3/2008
10/3/2009
COMBINED SINGLE LIMIT
(Ea accident)
$
I,000,000
BODILY INJURY
(Per person)
$
XXXXXXX
ALL OWNED AUTOS
SCHEDULED AUTOS
X HIRED AUTOS
X NON -OWNED AUTOS
BODILY INJURY
(Per acadent)
$
XXXXXXX
PROPERTY DAMAGE
(Per madent)
$
XXXXXXX
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
XXXXXXX
OTHER THAN EA ACC
$
XXXXXXX
ANY AUTO
NOT APPLICABLE.
$
XXXXXXX
AUTO ONLY: AGO
A
EXCESSIUMBRELLA LIABILITY
X OCCUR 0 CLAIMS MADE
DTSMCU11060SC718TIL08
10/3/2008
10/3/2009
EACH OCCURRENCE
$
1000000
AGGREGATE
$
1000000
$
XXXXXXX
UMBRELLA
O
$
XXXXXXX
DEDUCTIBLE FORM
$
XXXXXXX
RETENTION $
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANYCEFUMEETORIPARTNDED? CUTIVE
40230I6
10/I/2008
10/I/2009
TATU
X WCSLIM)T OTH-
Toav LIMITS ER
E.L. EACH ACCIDENT
$
100,000
EL. DISEASE - EA EMPLOYEE
$
100,000
Oyes, deIMEMBER EXCLUDED? NO
tle PRO antler
If SPECIAL
SPECIAL PROVISIONS below
E.L. DISEASE -POLICY LIMIT
$
$00,000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Re: All work. Certificate Holder is included as
Additional Insured as respects General Liability only if required by written contact and coverage applies only
as respects ongoing operations performed by Insured for the Certificate Holder. All coverage terms, conditions and exclusions of the policy apply.
3927209
City of Fort Collins
Attn: Purchasing Division
PO Box 580
Fort Collins, CO 80522-0580
SHOULD ANY OF THE ABOVE DESCRIBED 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 $0 SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES,
C
ACORD 255(20011081 For questions regarding this certificate, contact the number listed In the 'Producer'
CORPORATION 19RH