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Home My WebLink AboutGLB CONSTRUCTION - INSURANCE CERTIFICATEACORD,. CERTIFICATE OF LIABILITY INSURANCE oGLH DP DATE(MM/DD/YYYCO-1 06 02 09) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rich & Cartmill Ins of CO ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE of Colorado LLC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 8213 W. 20th Street Greeley CO 80634 Phone:970-356-8030 Fax:970-356-8032 INSURED GLH Construction, Inc. 780 E Garden Dr Windsor CO 80550 INSURERS AFFORDING COVERAGE INSURER A: Bituminous Insurance INSURER B Plnnacol Assurance. INSURER C INSURER D: INSURER E: NAIC # Cos 1 20095 GUVtKAIatJ 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. PE OF INSURANCE TRA,IABILITY ERCIAL GENERAL LIABILITY LAIMS MADE OCCUR POLICY NUMBER CLP3262772 POLICY EFFECTIVE DATE MM/DDIYY 04/01/09 POLICY EXPIRATION DATE MM/DD/YY 04/01/10 EACH OCCURRENCE LIMITS $ 1,000,000 PREMISES (Ea occurenca) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE s2,000,000 -COMP/OP AGG $ 2,OOO,OOO REGATE LIMIT APPLIES PER:PRODUCTS Y PRO LOCJECTLE A LIABILITY ANAUTO CAP3529215 04/01/09 04/01/10 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (Per accident) $ NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY -- -AUTO.ONLY,. EA ACCIDENT $' OTHER THAN EA ACC AUTO ONLY: _ AGG $ ANY AUTO $ A EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMSMADE CTJP2585015 04/01/09 04/01/10 EACH OCCURRENCE $ 5,000,000 AGGREGATE $5,000,000 $ DEDUCTIBLE $ X RETENTION $ 10 , 000 B _ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED?- 4028616 07/01/09 07/01/10 _ X TORY LIMITS I I ER E L. EACH ACCIDENT $ 1000000 E.L.DISEASE- EAEMPLOYEE $ 1000000 E.L. DISEASE - POLICY LIMIT $ 1000000 If yes, describe under SPECIAL PROVISIONS below OTHER A Leased / Rented CLP3262772 04/01/09 04/01/10 Limit $250,000 Equipment DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Certificate Holders are named as additional insured on the general liability policy but only with respect to liability arising out of the insureds operations on any and all operations by the insured for the certificate holder. 10 day cancellation provision still applies for non-payment.Project: 6115 Resource Recovery Farm Outlet Pipe. --- CANCELLATION City of Ft. Collins & Anderson Consulting Engineers, Inc. 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 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Michael J Schmitt CIC n ACORD CORPORATION 1988 AGUKU ZO (LUUI/UOI 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. ACORD 25 (2001/08)