HomeMy WebLinkAbout109256 BARKER CONSTRUCTION CO INC - INSURANCE CERTIFICATE (7)Client#: 20175
BARCO
ACORD. CERTIFICATE
OF LIABILITY INSURANCE
04/19/2010YYY)
PRODUCER
Flood & Peterson Ins., Inc.
Corporate Mailing Address:
P g
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.
P. O. Box 578
Greeley, CO 80632
I�n11
1NSURERS�AFFORDING COVERAGE
NAIC #
INSURED
V
INSURER A�.I Bituminous Insurance
Barker Construction Company, Inc
142 North Timberline Road
Fort Collins, CO 80524
I C D D
21
N'SURER B J PLinnacol Assurance
INSURER c
INSURER D:
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
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DD
POLICY EXPIRATION
DATE D
LIMITS
A
GENERAL LIABILITY
CLP3273039
05/01/10
05/01/11
EACH OCCURRENCE
$1 000 000
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RSES (E.ENTEDPREM
$300OOO
CLAIMS MADE FX1 OCCUR
MED EXP (Any one person)
$1 O 000
PERSONAL& ADV INJURY
$1 000 000
X PD Ded:1,000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
s2,000,000
POLICY X PRO-
JECT
A
AUTOMOBILE LIABILITY
ANY AUTO
CAP3537569
05/01/10
05/01/11
COMBINED SINGLE LIMIT
(Ea accident)
$1 ,000,000
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
X SCHEDULED AUTOS
BODILY INJURY
(Per accident)
$
X HIRED AUTOS
X NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
X Drive Other Car
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
$
DEDUCTIBLE
$ _
RETENTION $
B
WORKERS COMPENSATION AND
4033353
10/01/09
10/0111 O
X OR STATUS OTH-
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$1 OOO OOO
E.L. DISEASE - EA EMPLOYEE
$1 000 000
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$1 OOO OOO
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Certificate holder is named as additional insured, but only as respects
liability arising out of work performed by the named insured (Excluding
Workers' Compensation).General liability coverage is primary and
non-contributory.
[tl a:1ll I101_11 a: L•UI1] a a
ity-ofaFo`r 'Collin
Purchasing Departmen
PO Box 580
Ft'Collins, CO 52
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 'A0_ 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 #S523451/M523443 JZS 0 ACORD CORPORATION 1988
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.
ACORD 25-S (2001/08) 2 of 2 #S523451/M523443