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Home My WebLink AboutWRIGHT BALLARD CONSTRUCTION - INSURANCE CERTIFICATE (4)CERTIFICATE OF LIABILITY INSURANCE American Family Insurance Company ❑ American Family Mutual Insurance Company if selection box Is not Checked. 6000 American Pky Madison, Wisconsin 53783-0001 In3ured's Name and Address Agent's Name, Address and Phone Number (Agt,/DSt-) Wright Ballard Construction, Inc. Lesa Ringkjob (970-22M940) 6621 Aaron Drive 375 E. Horsetooth Bldg. 6 Ste. 100 Fort Collins, CO 80521 Ft. Collins, CO 80525 (008/316) This Certificate Is Issued es 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 listed below. This to to codify that poldlos of Insurance listed below have been issuedtothe Insured named above for the Polley period indloated, noM'INrstanding any requirement, tens or eonmtlon or any contract or other document with respect to which his certificate may be Issues or may pertain, the Insurance iff.ded by the poeyaedadorlbed herein is aublact I. ad the wane. evctuetone. and conditions Of Stroh policies. POLIC DATE TYPE OF INSURANCE POLICY NUMBER LIMITS OF LIABILITY EFFECTIVE E...RATION Mo PR De Mo Ywnara/ Homeo aodlly Injury entl Property pamagb Mobilehomeowners Liability Each Occurrence $ 1000 Bodily Injury and Property Damage BdatOWners Liability Each Occurrence $ ,000 Persona{ Umbrella Liability 6001V Injury and Properly Damage Each Occurrence $ 1000 Farm Liability & Personal IJabalty Farm/Ranch Liability Each Occur r $ 1000 i Employare LlebOity Each OccU'mncq $ 000 Workers Compensation and Statutory rest*araz+ Each Accident $ 100,000 Empioyara Liability t 05-X24845.91 02/18/2008 02/18/2009 Disease• Each Employes $ 100 ,000 Glseaso-Polity umit $ 500,000 General Liability Consist Aggregate $ 2.000 00o Products - Dom letedO station AggaW4 $ 2,000 000 X Commercial General Perewa.and Advertisin In'a $ 1,000 Liability(ocourrence). 05-X92387-05 12/22/2007 12/22/2008 eachoccunence $ 11000 000 ❑ Damage to Promises Rented to You $ 100 000 ❑ Medical Expense IAny One Parson $ 5 000 Each Oacuroncet t $ 1000 Busineasownsrs Liability A98raeataft $ ,000 Common Cause Limit $ 1000 Liquor Liability Aggregate omit $ 1000 Automobile Liability Bodily injury - Each Person $ 1000 ❑ Any Auto $ ❑ All Owned Autos Body, Wurv-Each Acctdsm .000 Property Damage $ ,000 ❑ Scheduled.Autos ❑ Hired Auto Bodily Injury and Property Damage combined $ ❑ Nonowned Autos ❑ ,000 Excess Liability ❑ Commercial Blanket Excess Each ocomrenaa/Aggregate $ 1000 Other (Miscetlaneotts Coverages) DESC91P I ION OF OPERATt The individual orpanners shown ad Insured ❑Hays ❑Havenol Certificate holder is listed as Additional Insured. elactacs-Oomd to be letecl as employees Under this Pit cy. tt atnU aggmgate It Bddel to each induced in dccurmnce limit entl la Indudetl In polity aggrsgmp. ocwmantalimit CepT1Kl'Ch791RifLot�,H�N1�YN�QfSbEss Should guy of the above described policies be canoelled before the "( days) . City of Fort Collins axplration date thereof, the company will endeavor to snail 30 failure Purchasing Department written notice to the Certificate Holder named, but to mad such notice shall impose no obligation or .lability of any kind upon the 'f0 P.O, Box 580 Qom any, Its a enta or representatives. days unless different shown. Ft, Collins, CO 80522 numger of days ❑ This oenties coverageon the date of issue only. The above described policies are subject to Cancellation in conformity with their terms and by the laws of the state of Issue. Fax If 221-6707 GATE 13 q ORIZEQ REPRE ATIVE 11/14/2008 U-201 Ed. 5100 Certificate Holder Stock No. 06668 Rev. 7/02 CERTIFICATE OF LIABILITY INSURANCE American Family Insurance Company q American Family Mutual Insurance Company if selection box Is not checked. 6000 American Pky Madiaon, Wisconsin 53783-0001 insured's Name and Address Agent's Name, Address and Phone Number (Agt,/Dist.) Wright Ballard Construction, Inc. Lesa Riingkjob (970 22"940) 6821 Aaron Drive 375 E. Horsetooth Bldg. 8 Ste. 100 Fort Collins, CO 80521 Ft. Collins, Co 80525 (008/316) This Certificate Is issued as a matter of Information only and confers no rights upon the Certificate Holder. Thia certificate does not amend, extend or alter the coverage afforded by this policies liatod below. 77 Tha Is to canify that porclos of Insurance listed below have bean issued to the insured named 4b0y6 for the porgy period inNeated, notwhhstanding any requirement, term or COstlNO of any contract or other WOUM,nt with massed to welch this sanifid810 may be Issued or may psnam. the Inaumnoe afforded by the p01101Je described herein is euulad to 0 the forme, exchrelpna, and dsndiliOrl" SBCh pollol, f. POL TYPE OF INSURANCE POLICY NUMBER LIMITS OF LIABILITY EFFECTIVE EXPIRATION Mo Oa Mo Dfl Yr Body Injury am Property Damago Homeowners/ $ MobilehomeownArs Liability Each Ocrunenc6 ,000 Soddy Injury and Property Damage Boetowners Liability each Os" dodos $ 1000 Bodily Prouty and Pmpeny Damage Personal Umbrella Liability Each Occurrence $ ,000 Paml Liability & Personal uabalry Farm/Ranch Liability Each ocwrr $ 1000 Farm Employer$ Llebllity Eaoh occurrence $ 000 Workers Compensation and statutory ««•++++++**• Eisen aaadem $ 100 ,000 Employers Liability t 05-X34846.91 02/16/2008 02/16/2009 DIPPPSa Each Employe, $ 100,000 Disease • Pdiw omit $ 500,000 consist aggregate $ 2.000 000 General Liability [1 Commercial General Products • Completed OperationsAggre ate $ 21000 000 Personal and Adnutiai,nl kjuFV $ 1,000 Liability (occurrence) 05-X92387-05 12122/2007 12/22/2008 each Oecurroccurrence$ 1,000 000 ❑ cameos to Premises Rented to You $ 100 000 ❑ Model Expands Any One Pareon) $ 5 Goo Each occunagcett $ 1000 BusineaeownersLiability Aggragamtl' $ 1000 Common Cause Limit $ '000 Liquor Liability Aggregate, Limit $ ,000 Automobile Liability Bodily Injury- Each Person $ ,000 ❑ Any Auto Bodily Injury Each Acddsm Cl All Owned Autos Property Damage $ ,000 ❑ Scheduled Autos ❑ Hired Auto ❑ Nonowned Autos Bodily Injury and Property Damage combined $ 000 ❑ Exceae Liability ❑ Commercial Blanket Excess Each OccunencdAggregala $ ,000 Other (Miscellaneous Coverages) DESCRIPI fON OF OPERATI ATION9/VBH RESTRICTfOrds EDIAI ITEMn tThe lndlvldualarpanneresnown as insured ❑Have ❑Havonot ,levied t0 be Covered ae em010y66a Under this pulley. Certificate holder is listed as Additional Insured. Prodpct$.cmepleted operations aggrag e, 18 equal tc each tt occurrence limit and Is Included In policy aggregate. a-AT� HdGt7 f ,�"i, Nkhl� Xa4%< CfbI�E39: , ..:::: its. G`AhIL` 4; r4±t`I N :� ; . � $,- -. ,` R., Should any of ibe above described ohotas be cancelled before the "( . City of Fort Collins expiration date thereof, the company vitro endeavor to mail 30. days) Purchasing Department P.O, Box 580 written notice to the Ce cate Holder Warned, but failure to man such notice shall impose no dbligation or liabilittyv of any kind upon the `t0 days unless different coin any, Its a ante ur ropresentatwea. numger of days shown, Ft, Collins, CO 80522 ❑ This certifies coverage, vn the dais of issue only. Theabove deserlbed policies are subject to cancellation in conformity with (heir terms and by the laws of the state of Issue. Fax If 221-6707 OAT El3 q HORIZE REPRE ATIVE 11/1412008 Iw U-201 Ed. 5100 Certificate Holder Stock No, 06668 Rev. 7/02