HomeMy WebLinkAboutGL HOFF COMPANY - INSURANCE CERTIFICATE (3)ACORD- CERTIFICATE OF LIABILITY INSURANCE
3DATE (MM/DD1YY
/26/2010 YY)
PRODUCER
Flood & Peterson Ins., Inc.
Corporate Mailing Address:
P 9
P. 0. Box 578
Greeley, CO 80632
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
'GL Hoff Company -
dba Hoff Construction
P.O-., Box -7448
Loveland, CO 80537
INSURER A: Travelers Insurance Company
INsuRERB: Pinnacol Assurance "
INSURER C:
-
INSURER D:
INSURER E:
COVERAGES
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
D
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDD/YY
POLICY EXPIRATION
DATE MM/DD
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE a OCCUR
X PC Ded:2,500
DTC0325D6564
04/01/10
04/01/11
EACH OCCURRENCE
$1000000
PREMISES (Fa DAMAGE TO RENTED
$300 000
MED EXP (Any one person)
$5 000
PERSONAL BADV INJURY
$1 000 000
GENERAL AGGREGATE
s2,000,000
[GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY-X] PROECT LOC
J
PRODUCTS - COMP/OP AGG
s2,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS ..
NON -OWNED AUTOS
810325D6564T
04/01 /10
04/01/11
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
"(Per accident)
$"
X
PROPERTY DAMAGE
(Per accident)
$ -
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
A
EXCESS/UMBRELLA LIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $ 10000
DTSMCUP325D6
04/01/10
04/01/11
EACH OCCURRENCE
$1 000000
AGGREGATE
$1 00O 000
$
$
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
2242590
04/01 /10
04/01/11
OTH-
X OR LIMIT I PR
E.L. EACH ACCIDENT
$5OO OOO
E.L. DISEASE - EA EMPLOYEE
$500OOO
E.L. DISEASE - POLICY LIMIT
$500OOO
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
City of Fort Collins
Attn: John Stephen.
215 N. Mason St., Second Floor
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 I0_ 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 REPRESENTATIVE
ACORD 25 (2001/08) 1 of 2 #S516974/M516937 CAZ 0 ACORD CORPORATION 1988