HomeMy WebLinkAboutBEMAS CONSTRUCTION INC - INSURANCE CERTIFICATEAC®RQ CERTIFICATE OF LIABILITY INSURANCE
0/06 2010Y)
10/06/2010
PRODUCER 1-303-534-4567
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
IMA of Colorado, Inc.
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1550 17th Street
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Suite 600
Denver, CO 80202
INSURERS AFFORDING COVERAGE
INSURED
Bemas Construction, Inc.
INSURERA:First Mercury Insurance Co Swett 6 Crawford
INSURER B: Hartford Insurance Co. of Midwest
80 Inverness Drive East
INSURER C:National Union Fire Ins Co of PA (Swett 6 Crawford)
INSURERD:Pinnacol Assurance
Englewood, CO 80112-5114
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.
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION
LIMITS
A
GENERAL LIABILITY
FMMA0030562
09/30/10
09/30/11
EACH OCCURRENCE
$ 1,000,000
FIRE DAMAGE (Any one fire)
$ 100,000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 1XI OCCUR
MED EXP Any one person
$ 5 , 000
PERSONAL BADVINJURY
$1,000,000
X PD Ded:$10,000
GENERAL AGGREGATE
$2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2 , 000 , 000
PRO LOC
POLICY X JECT
B
AUTOMOBILE
X
LIABILITY
ANY AUTO
34UENIQ7601
09/30/10
09/30/11
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
$
X
X
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
C
EXCESS LIABILITY
BE19714998
09/30/10
09/30/11
EACH OCCURRENCE
$1,000,000
X OCCUR CLAIMSMADE
AGGREGATE
$1,000,000
$
DEDUCTIBLE
$
RETENTION $ 0
D
WORKERS COMPENSATION AND
4032634 - CO ONLY
10/01/10
10/01/11
X WCSTATU- OTH-
T YLIMT E
E.L. EACH ACCIDENT
$1,000,000
EMPLOYERS' LIABILITY
E.L. DISEASE - EA EMPLOYE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1, 000, 000
OTHER
E
E
E
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS -
City of Fort Collins
PO Box 580
Fort Collins, CO 80522-0580
USA
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
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25-S (7/97) jweir85
17798789
L-
O ACORD CORPORATION 1988
F
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 (7/97)
3:4
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