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Home My WebLink AboutGLM CONSTRUCTION - INSURANCE CERTIFICATEACORD. CERTIFICATE OF LIABILITY INSURANCE OP ID DP DATE (MMIDDIYYYY) GLHCO-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 OVERAGES INSURERS AFFORDING COVERAGE INSURER A: Bituminous Insurance Cos. INSURER B: Plnnacol Assurance - - - -- - INSURER C: INSURER D: INSURER E: NAIC # 20095- v 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 LTR DD' NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 (Ea occurence) $ 100,000 A X X COMMERCIAL GENERAL LIABILITY CLP3262772 04/01/09 04/01/10 -PREMISES MED EXP (Any one person) $ 5,000 CLAIMS MADE 120 OCCUR PERSONAL & ADV INJURY $ 1,000,000 ,. GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 POLICY PRO LOC JECT A AUTOMOBILE LIABILITY ANY AUTO CAP3529215 04/01/09 04/01/10 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY - -- AUTO ONLY - EA ACCIDENT -$ _.. OTHER THAN- EA ACC AUTO ONLY: $ .. " _. ANY AUTO - $ - - EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 5,000,000 AGGREGATE s5,000,000 A X OCCUR CLAIMSMADE CUP2585015 04/01/09 04/01/10 $ DEDUCTIBLE $ X RETENTION $ 10 , 000 WORKERS COMPENSATION AND X TORY LIMITS ER E.L. EACH ACCIDENT $ 1000000 B EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? 4028616 07/01/09 07/01/10 E.L. DISEASE - EA EMPLOYEE $ 1000000 ., If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1000000 OTHER A Leased / Rented CLP3262772 04/01/09 04/01/10 Limit $250,000 ,Equipment DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City of Ft. Collins is 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 . CERTIFICATE HOLDER CANCELLATIUN City of Fort Collins 300 Laporte Ave Fort Collins CO 80522 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 ACORD 25 (2001/08) U AGUKU CUKNUKA I IUN 1Utftli 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. AGORD 25 (2001/0S)