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HomeMy WebLinkAbout168787 GOLDEN TRIANGLE CONSTRUCTION - INSURANCE CERTIFICATEClient#: 51920 8GOLDTRII ACORD,. CERTIFICATE OF LIABILITY INSURANCE F D"DD/ 12/0 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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). PRODUCER Willis of Colorado, Inc. 720 South Colorado Boulevard Suite 60ON CONTAC NAME: PHONE 303 722-7776 FAX 303-722-8862 A/C No Ext : A/C, No : E-MAIL ADDRESS: Denver, CO 80246 CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Golden Triangle Construction, Inc. 700 Weaver Park Road Longmont, CO 80501 INSURER A: CNA Insurance Companies B6486 is S ialty Insurance Com INSURER B : p ChartSpecialty 26883 Pinnacol Assurance INSURER CINSURER 41190 DOneBeacon American Insurance Co 20621 INSURER E : - INSURER F : , COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDLPUBR INSR IWVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx� OCCUR .: TCP2022866738 12/31/2010 12/31/2011 EACH OCCURRENCE $11000000 PRAMAGE NTED EM SESOEaEoccurrence) $500,000 MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY X JFCT PRO X LOC PRODUCTS - COMP/OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS Physical Damage C2022866741 ACV less Ded 12/31/2010 _ 12/31/2011 COMBINED accident) ) SINGLE LIMIT $1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ $ B UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE BE23465072 12/31/2010 12/31/2011 EACH OCCURRENCE s8,000,000 AGGREGATE $8 000 000 DEDUCTIBLE RETENTION $ 10,000 $ X $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below - NIA 4013024 10/01 /2010 10/01 /2011 X WC STAT I OTH- T ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEEI $1,000,000 - - E.L. DISEASE - POLICY LIMIT $1,000,000 D Lease/Rent Equip Owned Equip 790005057 12/31/2010 12/31/2011 $100,000 less Ded ACV less Ded DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ft. Collins ACCORDANCE WITH THE POLICY PROVISIONS. 215 N. Mason PO BOX 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80524 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S743286/M742842 8MJON