HomeMy WebLinkAboutGLH CONSTRUCTION INC - INSURANCE CERTIFICATE-
CERTIFICATE OF LIABILITY INSURANCE OPID GLHCOPDATE (MM/DD/YYYY)
l 03/30/10
Rich & Cartmill Ins of CO
of Colorado LLC
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
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFUKmA I IUN
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 #
INSURER A: Bituminous Insurance Cos 20095
INSURER B: Pinnacol Assurance
INSURER C: Travelers Indemnity CO
INSURER D:
INSURER E:
COVERAGE5
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
A
NSR
X
TYPE OF INSURANCE
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE � OCCUR
POLICY NUMBER
CLP3272485
POLICY EFFE TIVE
DATE MMIDDIYYYY
04/01/10
POLICY EXPIRATI N
DATE MMIDD/YYYY
04/01/11
LIMITS
URRENCE
EACH OCCTO
$ 1,000,000
PREMISES (Ea occu.....
$100,000
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000 _
GENERAL AGGREGATE
s2,000,000
PRODUCTS - COMP/OP AGG
s2,000,000 "
GENT AGGREGATE LIMIT APPLIES PER:
+
POLICY PROT LOC
JE
A
AUTOMOBILE
LIABILITY
ANY AUTO
CAP3537105
04/0.1/10
04/01/11
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
CUP2587673
04/01/10
04/01/11
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$5,000,0007
$
DEDUCTIBLE
$
X RETENTION $ 10 , 000
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PRO PR IETOR/PARTNER/EXECUTIVF
OFFICER/MEMBER EXCLUDED? Iu1
(Mandatory in NH)
If yes, describe under
SPECIAL PROVISIONS below
4028616
07/01/09
'
07/01/10
_
X I TORY LIMITS ER
E.L. EACH ACCIDENT
$1000000
E.L.DISEASE - EA EMPLOYEE
$ 1000000
E.L. DISEASE - POLICY LIMIT
$ 1000000
OTHER
C
C
Leased/Rented Equp
Installation Float
QT-660-5895N629
04/01/10
04/01/11
Limit $250,000':
Floater $50,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I 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.
ICO TICIP`ATC unt nCR CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
CITF-AN DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
City of Ft. Collins & Anderson NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Consulting Engineers, Inc. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS.OR
Purchasing Division REPRESENTATIVES.
PO BOX 580 AUTHORIZED REPRESENTATIVE
Fort Collins CO 80522-0580 Michael J Schmitt CIC
�J
ACORD 25 (2009101) v 1000-&Wvq W... .
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