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Home My WebLink About109256 BARKER CONSTRUCTION CO INC - INSURANCE CERTIFICATE (4)Client#: 20175 BARCO ACORDTM CERTIFICATE OF LIABILITY INSURANCE 04/24/2809 /09D/YYYY) 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 `-- --"'' INSURERA: Bituminous Insurance. _ Barker;_Construction Company, Inc INSURER B: Pinnacol Assurance 142,North Timberline Road INsuRERc: FortvCollins, CCI 80524 ' ;.. INSURERD: _.. _.... _...__ .., .._ _., ' INSURER E: i (`(1VFRArFR 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 MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS A GENERAL LIABILITY - CLP3263597 05/01/09 05/01/10 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY pCLAIMS MADE 51OCCUR PREMISES (Ea occurrD nce) $3OO OOO MED EXP (Any one person) $10 O00 PERSONAL & ADV INJURY $1 OOO 000 X Ded:1,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 POLICY .X PRCTO LOC JE A- AUTOMOBILE LIABILITY, ANY AUTO CAP3529866 05/01/09 "' 05/01/10.. - COMBINED SINGLE LIMIT (Eaaccident) ,. - $1,0002000 X BODILY_..,... ersloN;URY ...... . ....... $ ALL OWNED AUTOS_„ SCHEDULED AUTOS ';:•.:. X BODILY 'INJURY (Per accident) $ ` HIRED AUTO&. ,:. NON -OWNED. AUTOS„ .. _ ._ X X. PROPERTY DAMAGE (Per accident) $ Drive Other Car GARAGE LIABILITY - AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO ' $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR, CLAIMS MADE Is EDEDUCTIBLE .RETENTION.—_$....---"— B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE 4033353 10/01 /08 T10/01 /09 X WC STATii=' - ' OTH- ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1 2000,000 OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $1 ,000,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Certificate holder is named as additional insured, but only as respects liability arising out of work performed by the named insured (Excluding Workers' Compensation). General liability coverage is primary and non-contributory. (See Attached Descriptions) VCr[ I Ir11.N 1 r- nULlJCR GANGtLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fort Collins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL .10_ DAYS WRITTEN Purchasing Department NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL PO Box 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Ft Collins , CO 80522 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE AL;UKU L5 (1UU1/US) 1 of 3 #S443908/M442407 ,JzS 0 ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. r+�.vr%U ca-a kcuu uVa) 2 0t 3 95443908IM442407 DESCRIPTIONS (Continued from Page 1) 5/12/09 Emailed to Cheryl @ Barker Construction. Mailed to Certificate Holder. Per Cheryl's request. 4/28/09 Mailed Renewal Certificate to Certificate Holder. wrvia tas tzuu-iiut$) J OT J FFS443yUS/M4424U1