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HomeMy WebLinkAbout168787 GOLDEN TRIANGLE CONSTRUCTION INC - INSURANCE CERTIFICATE (13)Client#: 51920 8GOLDTRII ACORD_ CERTIFICATE OF LIABILITY INSURANCE ­DATE9/22/2011 s/2z/zo11 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 Suite60ON Denver, CO 80246 CONTACT . NAME: PHONEo, 303 722-7776 FAX 303-722-8862 AIC N Exl : A/O, No E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAICII INSURER A: CNA Insurance Companies B6486 INSURED Golden Triangle Construction, Inc. 700 Weaver Park Road Longmont, CO 80501 INSURER B: Chards Specialty Insurance Corn 26883 INSURER CPinnacol Assurance 41190 INSURER D: OneBeacon 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 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUB MD POLICY NUMBER POLICY EFF MM/DDYYY /Y POLICY UP MM/DDNYVY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR 2022866738 12/31/2010 12/31/2011 EACH OCCURRENCE $1,000,000 PREMISES Ea oocu D nce $500OOO NED UP (Any one pumon) $5000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE L 'MITAPPLIES PER: POLIOY X PRO JCT X LOC E PRODUCTS-COMP/OPAGG s2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED IREAUTOS Damg C2022866741 12/31/201012/31/2011 COMBIEaaceidenEDlSINGLE LIMIT N $1,000,000 BODILY INJURY (Per person) $ IX BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ B X UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE BE23465072 12/31/201012/31/2011 EACH OCCURRENCE $$000000 AGGREGATE s8,000,000 DED X RETENTION $10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECI- IVE� OFFICEWMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4013024 - _ 10/01/2011 01/01/201 X WC STATU- OTH- TORY LIMITS Eft E.L. EACH ACCIDENT $1 000 000 E.L. DISEASE -.EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 D Lease/Rent Equip Owned Equip - 790005057 1213112010 12/31/2011 $100,000 less Ded ACV Less DED DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) City of Ft. Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 215 N. Mason ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 Fort Collins, CO 80524 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S857230/M856731 8RSMI