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Home My WebLink AboutBT CONSTRUCTION - INSURANCE CERTIFICATE (4)MINVDD� ACORDrm CERTIFICATE OF LIABILITY INSURANCE 0/1/20]o I DAT9/30/20 9Y) PRODUCER Lockton Companies, LLC Denver 8110 E Union Avenue Suite 700 Denver CO 80237 (303)414-6000 INSURED BT Construction, Inc. 1047338 9885 Emporia Street Henderson, CO 80640 !`nXICDA1 _=Q INSURERA: Travelers INSURER C. INSURER E COVERAGE I NAIC # Assurance 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 AOD'L INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDDNYI POLICY EXPIRATION DATE (MMIDDM) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE I —XI OCCUR DTC00605C7183ND09 10/3/2009 10/3/2010 DAMAGE TO RENTED PREMISES Be occurence $ 300,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMPIOP AGO $ 2000000 PRO - POLICY X JECT X LORD A AUTOMOBILE LIABILITY ANY AUTO DT8100605C718'rIL09 10/3/2009 10/3/2010 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ XXXXXXX ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ XXXXXXX HIRED AUTOS NON -OWNED AUTOS X PROPERTY DAMAGE (Per accitlent) $ XXXXXXX GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S XXXXXXX ANY AUTO NOT APPLICABLE, OTHER THAN EA ACC $ XXXXXXX AUTO ONLY: AGG $ XXXXXXX A EXCESSIUMBRELLA LIABILITY X OCCUR CLAIMS MADE D'rSMCUP0605C718TIL09 10/3/2009 10/3/2010 EACH OCCURRENCE $ 1,000,000 AGGREGATE IS 11000,000 $ XXXXXXX ❑ UMBRELLA X S XXXXXXXr DEDUCTIBLE FORM $ XXXXXXX RETENTION $ 1' WORKERS COMPENSA'I ION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNEWEXECUTIVE 4023016 10/1/2009 10/1,12010 X WC STATIJ- OTH- TORV LIMIB ER E. L EACH ACCIDENT $ 100,000 E. L. DISEASE - EA EMPLOYEE $ 100,000 OFFICERIMEMBER EXCLUDED? It yes. describe under SPECIAL PROVISIONS below No E.L. DISEASE -POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS RE: City of Port Collins Contract No. 11951. City of Port Collins is included as Additional Insured as respects General Liability. c 1 "Dyoo SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fart Collins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN Alin: Purchasing NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 215 North Mason St, IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Ft. Collins, CO 80524 REPRESENTATIVES. AUTHORIZED REPRES T E rle /_� 4/ ACORD 25(2001/081 For QuestionsRardlao this ce,tirican. contact the number inted in the'Producre Section above and soeciry 6e client co0e'9TCONOf'. C(`()RrT (.nPPnRATInN 9QRA ACORD,. CERTIFICATE OF LIABILITY INSURANCE 10/172010 GATE (MMIDDNYYYI 9/130/2009 PRODUCER Lockton Companies, LLC Denver 8110 E Union Avenue Suite 700 Denver CID 80237 (303)414-6000 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED BT Construction, Inc. 1047338 9885 Emporia Street Henderson, CO 80640 INSURER A: Travelers Prop. Casualty INSURERS: Pinnacol Assurance INSURER C : INSURER D. INSURER E COVERAGES BTCONOI VU 04Ui I IrIUA It Ur NbUKANGt VUes NU I WNS I I IV It A WN I NAaa ec l Wetly l Ne lbaVINU INSIIRERISI. AHTHORI)FD RFPRFSENTATIVF OR PRODUCER AND THE CERTIFICATE HOLDER. 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 ADDTI INSRDI TYPEOFIN SURANCE POLICY NUMBER POLICY EFFECTIVE DATE(MMIDDIVY) POLICY EXPIRATION DATE(MMIDDNY) LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 A X COMMERCIAL GENERAL LIABILITY DTC00605C7181ND09 10/3/2009 10/3/2010 DAMAGE TO RENTED PREMISES F .... Ic1R.J S 300000 CLAIMS MADE FRI OCCUR MED EXP (Any one person) S $ 000 PERSONAL & ADV INJURY $ 1000 000 GENERAL AGGREGATE S 2,000,000 GENT AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMPIOP AGG S 2000000 PRO- POLICYNI JECT X LOC A AUTOMOBILE LIABILITY ANY AUTO DT8100605C718TI1,09 10/3/2009 10/3/2010 COMBINED SINGLE UMI'I (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) S XXXXXXX ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ XXXXXXX HIRED AUTOS NON-OWNEDAUTOS X PROPERTY DAMAGE (Per accidenp $ XXXXXXX GARAGE LIABILITY AU'(O ONLY - EA ACCIDENT $ XXXXXXX ANY AUTO NO'I'AI'PI,ICABLIF on EN THAN BA ADC $ XXXXXXX AD rO ONLY. AGG $ XXXXXXX A EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMS MADE D 1SMCUP0605C718TIL09 10/3/2009 10/3/2010 EACH OCCURRENCE $ 1,000,000 AGGREGATE S 1,000,000 S XXXXXXX UMBRELLA EXI S XXXXXXX DEDUCTIBLE FORM S XXXXXXX RETENTION $ t1 WORKERS COMPENSATION AND 4023016 10/1/2009 10/1/20;0 X WCSTATtI- oTH- TORY LIMITS ER EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMSER EXCLUDED? E.L EACH ACCIDENT $ 100,000 F.L. DISEASE - EA EMPLOYEE $ 100 000 yEdescdee „Seer SPECIAL PROVISIONS below NO EL DISEASE -POLICY LIMI( $ 500,000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Re: All work. Certificate Holder is included as Additional Insured as res Iccts General Liability only if required by written contact and coverage applies only as respects ongoing operations performed by Insured for the Certificate ?Ioldei. All coverage terms, conditions and exclusions of the policy apply. 'JuL/LUS 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 30 DAYS WRITTEN Attn: Purchasing Division 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 Fort Collins, CO 80522-0580 REPRESENTATIVES. AUTHORIZED REPRESE T E , i7ar, V/ Acnan 94 r9nn41nal l'.1 SNnne,00e.dlonU,11cndiricab.a.e,ee,wo,,,,n,eerIle;ee In d,e'Prndu... semen zb.- endeuecav M1e <bent code �ewONDr. GeACORD CORPORATION 1988