Loading...
HomeMy WebLinkAboutCLARK CONSTRUCTION CO - INSURANCE CERTIFICATE (2)cnenm zTuai GLAGU ACORD'. CERTIFICATE OF LIABILITY INSURANCE 02/25/09D""YY) PRODUCER 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 ALTER THE COVERAGE AFFORDED,BY THE POLICIES BELOW. P.O Box 270370 - Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC # INSURED..,''.: • INSURER A: Travelers InsuranceCompany I ,Clark! Construction Co., Inc. INSURER B: Pinnacol Assurance :.-2956:Ginnali Drive - INSURER C: - --• ' Loveland,*CO 80538 • � INSURER D: .. - INSURER E:- COVERAGES" 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD/VY POLICY EXPIRATION DATE (MM/DDfYYI LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FYOCCUR X PD Ded:2,500 DTCO283P245AIND09 03/01/09 03/01/10 - EACH OCCURRENCE $1000000 DAAMIAGE TO RENTEDPREoccurrence)ISES (Ea $300OOO MED EXP (Any one person) $5 000 PERSONAL & ADV INJURY $1 000 OOO GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO-' JECT LOC PRODUCTS - COMP/OP AGG s2,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL,OWNED'AUTOS, SCHEDULED AUTOS I' '- HIRED'A0TOS NON -OWNED AUTOS -• • •• DT810283P245ATIL09 - 03/01/09 ' ' - 03/01/10 - _ -- •• - COMBINED SINGLE LIMIT .(Eaaccident). .. - $1,000,000 - X �BODILY INJURY (Per person _.-... - .$._=' X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ ' GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ A EXCESS/UMBRELLA LIABILITY X OCCUR FICLAIMS MADE DEDUCTIBLE X RETENTION $ 10000 DTSMCUP283P245ATIL 03/01/09 03/01/10 EACH OCCURRENCE $1000000 AGGREGATE $1 00O 000 $ $ -S WORKERS CGMPENSA1 ION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 4000003 04/01 /08 04/01/09 04/01 /09 04/01/10 X WC SLIMIT ER E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE $500,000 E.L. DISEASE - POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS I.AN%,CLLAI IVN 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 3_ DAYS WRITTEN P.O. BOX 580 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Fort Collins, CO 80522 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE y- -%k,umU L, VIJul'UC) 1 of 2 #M437643 _ SXC © 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. AGUKU ZS-5 (ZUUI/US) 2 of 2 #M437643