HomeMy WebLinkAboutR R SWERDFEGER CONSTRUCTION - INSURANCE CERTIFICATEACORD,„ CERTIFICATE OF LIABILITY INSURANCE DATE 12/29/200829/08
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
SCA Insurance - Pueblo ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1414 West 4th Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Pueblo CO 81004
(719) 544-2533
ALTER
THE
COVERAGE AFFORDED BY THE
POLICIES
B
INSURERS AFFORDING
COVERAGE
NAIC #
INSURED
INSURERA
—__
The
Travelers Indemnity
25658
K. R. Swerd£eger Construction, Inc.
_ _ComPdn _
INSURERS
__..
The
_.___
Travelers Casualt
_ -Property__._ _._......
25679
___ _
421 E.INDUSTRIAL BLVD.
INSURERC:
PUEBLO WEST CO 81007
_INSURER D'.
.0 V CPUPium)
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 DD'___ .__. _.__._
LTR F R NCE POLICY NUMBER POLICY EFFECTIVE POLICY E%PIRATION
DATE MMIDDIY DATE MMIODw LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 000, 000_
A
X COMMERCIAL GENERAL LIABILITY
VTHC0647D7194TIA09
1/1/2009
1/1/2010
DAMAGE76 RENTED __
(Ea occurence).
.1
300,000
CLAIMS MADE I X, I OCCUR
-PREMISES
MED EXP(Any one person)
_$
$ 5,000
PERSONAL &ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
PRODUCTS, COMP/OPAGG
S 2,000,000
POLICY X PRO-
OC
E T_
_-
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
$
B
X
ANY AUTO
VTC2JCAP647D7182TILO
1/1/2009
1/1/2010
(Ea accident)
1,000,000
ALL OWNED AUTOS
- _
BODILY INJURY
$
SCHEDULED AUTOS
(Per person)
X
HIREDAUTOS
BODILY INJURY
S
X
NON -OWNED AUTOS
(Per accltlennt) q
-
--------------------------
PROPERTY DAMAGE
$
(Per accident)
GARAGE LIABILITY
-
AUTO ONLY EA ACCIDENT
--_
$
-S
ANY AUTO
---
OTHER THAN EAACC
AUTO ONLY'. AGO
S
E%CESSIUMBRELLA LIABILITY
EACHOCCURRENCE
$ 10,000,000
H
X OCCUR I __ CLAIMS MADE
VTSMJCUP647D7201TILO
1/1/2009
1/1/2010
AGGREGATE
$ 10, 000,000
$
DEDUCTIBLE
S
X RETENTION 5 10,000
$
A
WORKERS COMPENSATION AND
VTRKUB647D71709
1/1/2009
1/1/2010
X WC STATU H.
TORY IIMQB
EMPLOYERS' LIABILITY
_ER._.._
ANY PROPRIETOR/PARTNERIEXECUTIVE
E_EACH ACCIDENT
$ 1,000,000
OFFICER/MEMBER EXCLUDED?
E.I. DISEASE - EA EMPLOYEE
$ 1,000,000
Had, describe under
-------'- '-
- ----
SPECIAL PROVISIONS below
EL DISEASE -POLICY LIMIT
S 1,000,000
OTHER
I
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
PROJECT: WATER, WASTEWATER, 5 STORMWATER UTILITY PROPOSAL #P951
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
CITY OF FT. COLLINS DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
215 N. Mason St IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES,
FT. COLLINS CO 80522 AUTHORIZED REPRESENTATIVE
ACORD 25 (2001/08) (F ArnRn nn RRn RATinM 10AR
Pace 1 of 1
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.
12/29/2008
AGORD 25 (2001/08)
P`] 2 of ].