HomeMy WebLinkAboutBT CONSTRUCTION - INSURANCE CERTIFICATE (3)DATE (MM/DD/YYYY)
ACORD. CERTIFICATE OF LIABILITY INSURANCE 10/1/2009 6/4/2009
PRODUCER Lockton Companies, LLC Denver THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
8110 E Union Avenue ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Suite 700 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Denver 80237 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
(303) 414-6000
INSURED BT Construction, Inc.
1047338 9885 Emporia Street
Henderson, CO 80640
CnVFRAnFR BTCON01 VIJ
INSURERS AFFORDING COVERAGE NAIC #
INSURER A: Travelers Prop. Casualty
INSURER B : Pinnacol Assurance
INSURER C
INSURER D :
INSURER E
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THI
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
ADVL
-
POLICY EFFECTIVE
POLICY EXPIRATION
LTR
INSRD
- TYPE OF INSURANCE
POLICY NUMBER
_
DATE (MM/DD/YY)
DATE (MM/DD/YY)
_
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
DTC00605C718IND08
10/3/2008
10/3/2009
PREMDAMAGE TO
Ea oNcurence
$ 300,000
MED EXP (Any one person)
$ $ 000
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000,000
PRO -
ri POLICY X JECT X LOC
A
AUTOMOBILE
LIABILITY
ANY AUTO
DT8100605C718TIL08
10/3/2008
10/3/2009
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
X
BODILY INJURY
(Per person)
$ XXXXXXX
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Per accident)
$ XXX��X
HIRED AUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE
(Per accident)
$ XXXXXXX
-
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$ XXXXxxX
NOT APPLICABLE
ANY AUTO
OTHER THAN EA ACC
$ XXXXXXX
$ XXXXXXX
AUTO ONLY: AGG
A
EXCESS/UMBRELLA LIABILITY
X OCCUR CLAIMS MADE
DTSMCUP0605C718TIL08
-
10/3/2008
10/3/2009
EACH OCCURRENCE
$ 1 000 000
AGGREGATE
$ 1,000,000
$ XXXXXXX
' UMBRELLA
$ XXXXXXX
DEDUCTIBLE X FORM
$ XXXXXXX
RETENTION $
WORKERS COMPENSATION AND
4023016
10/1/2008
10/1/2009
X WC STATTORY U- OTH-
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$ 100,000
E.L. DISEASE - EA EMPLOYEE
$ 100,000
OFFICER/MEMBER EXCLUDED?
If yes, descdbe under No SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$ 500,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: CKT. 548 — Harmony to Trilby.
10557591
Cityy of Fort Collins
P.0 Box 580
Ft. 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
AUTHORIZED REPRES T E ,
Zw_*1.fd�lA-
ACORD 25 (2001/08) For questions regarding this certificate, contact the number listed in the' Producer' section above and specify the client code'BTCONor. (OFACORD CORPORATION 1988