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Home My WebLink About166269 GARNEY CO INC - INSURANCE CERTIFICATE (4)Certificate of Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFIGV'E HOLDER. THIS CERTIFICATE IS NOT AN INSURANCE POLICY AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. POLICY LIMITS ARE NO LESS THAN THOSE LISTED ALTHOUGH POLICIES MAY INCLUDE ADDITIONAL SUBLIMIT(LIMITS NOT LISTED BELOW This is to Certify that Carney Construction 7911 Shaffer Parkway NAME AND ADDRESS 1. Liberty °FINSURED Littleton CO 80127 Mutual is, al the issue date of this cenifiwte, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ies) is subject ro all their terns, exclusions and Conditions and is not altered by any requirement, tern or condition of any contract or other document with respect to which this cenificate may be issued. EXP DATE TYPE OF POLICY ❑ CONTINUOUS ❑ EXTENDED POLICY NUMBER LIMIT OF LIABILITY ® POLICY TERM WORKERS COMPENSATION 10/1/2012 WA2-64D-426942-731 COVERAGE AFFORDED UNDER WC LAW OF THE FOLLOWING STATES: AL,AR,AZ,CO,FL,GA,IA,KS,KY, MO,MS,NE,NM,OK,TN,TX,VA EMPLOYERS LIABILITY Bodily ln'uryby Accident 1000000 Each Accident Bodily Injury By Disease 1 000 000 Pot Bodily Injury By Disease 1 000 000 COMMERCIAL GENERAL LIABILITY 10/1/2012 TB2-641-426942-721 General Aggregate $2,000,000 Products / Completed Operations Aggregate ❑ OCCURRENCE 2,000,000 ❑ CLAIMS MADE Each Occurrence 1 Personal & Advertising Injury 1000000 Per Person' mra /Orgation RETRO DATE Dtt��yt300,000 Fire Legal V0,000 Medical AUTOMOBILE LIABILITY 10/1/2012 AS2-641-426942-711 B 1. And RD, tCombine Limit $2,000,000 B.I. And P.D. Combined r�I M OWNED Each Person Each Accident or Occurrence 0 NON -OWNED 0 HIRED Each Accident or Occurrence OTHER ADDITIONAL COMMENTS See Addendum Attached. Ifthe certificate expiration date is continuous or extended term, you will be notified ifcovemge is terminated or reduced before the certificate expiration date. NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.) BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT C�6CEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST (1(J DAYS NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO: Re: Canal Importation Ponds/Outfall-Work Order #11 rCity of Fort Collins, Colorado t o PO Box 580 Lort Collins CO 80522 J Liberty Mutual Insurance Group 1' Laura Rudolph St. Louis / 0442 AUTHORIZED REPRESENTATIVE 12250 Weber Hill Road St. Louis MO 63127 800-392-9223 9/19/2011 OFFICE PHONE DATE ISSUED This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those Companies NM 772 07-10 LDI COI 268896 02 11 Certificate of Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFICATE HOLDER THIS CERTIFICATE IS NOT AN INSURANCE POLICY AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. POLICY LIMITS ARE NO LESS THAN THOSE LISTED ALTHOUGH POLICIES MAY INCLUDE ADDITIONAL SUBLIMIT/LIMITS NOT LISTED BELOW This is to Certify that Carney Companies Inc 1333 NW Vivion Road NAME AND •'� Liberty ADDRESS OF INSURED Mutual® Kansas City MO 64118 is. at the issue date fthis certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ies) is subject to all their terms, exe l usions and Conditions and is not altered by any requirement, term or condition of any contract or other document with respect to which this cenificate may be issued. EXP DATE TYPE OF POLICY ❑ CONTINUOUS ❑ EXTENDED POLICY NUMBER LIMIT OF LIABILITY ® POLICY TERM WORKERS COMPENSATION 10/1 /2012 WA2-64D-426942-731 COVERAGE AFFORDED UNDER WC LAW OF THE FOLLOWING STATES: AL,AR,AZ,CO,FL,GA,IA,KS,KY, MO,MS,NE,NM,OK,TN,TX,VA EMPLOYERS LIABILITY Bodily ln'nryby Accidem 1 OOO OOOEad,Acciden, Bodily Injury By Disease 1 000 000 Bodily Injury By Disease 1 000 000 COMMERCIAL GENERAL LIABILITY 10/1/2012 TB2-641-426942-721 General Aggregate $2,000,000 Products / Completed Operations Aggregate ❑ OCCURRENCE 2 00,000 ❑ CLAIMS MADE Each Occurrence 1 Personal & Advertising Injury 1000000 Per Person/Orgamzaaon RETRO DATE tt1I GSrYO0,000 Fire Legal TT0,000 Medical AUTOMOBILE LIABILITY 10/1/2012 AS2-641-426942-711 Each AccidentCoSingle Limit $2,000,000 B.I. And P.D. Combined OWNED Each Person Each Accident or Occurrence NON -OWNED rat LJ HIRED Each Accident or Occurrence OTHER ADDITIONAL COMMENTS RE: 7089 - Water, Wastewater and Stormwater utilities Infrastructure Design and Construction Services Contractor. City of Fort Collins is an additional insured under the General Liability policy if required by a written contract with the Named Insured, but only for the coverage and limits provided by the policy and the additional insured endorsement. Ifthe certificate expiration date is continuous or extended teen, you will be notified ifcovemge is terminated or reduced before the certificate expiration date. NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.) BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT %A6CEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST b� DAYS NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO: Liberty Mutual Insurance Group 7089 City of Fort CollinsC-V-0L�Lc1m�� Purchasing Division Laura Rudolph P.O. Box 580 St. Louis / 0442 AUTHORIZED REPRESENTATIVE 12250 Weber Hill Road 215 North Mason Street, 2nd Flolor St. Louis MO 63127 800-392-9223 9/19/2011 Lort Collins CO 80522 I OFFICE PHONE DATE ISSUED This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those Companies NM 772 07-10 LDI COI 268896 02 11 Liberty Mutual 12250 Weber Hill Road St. Louis MO 63127 City of Fort Collins Purchasing Division P.O. Box 580 215 North Mason Street, 2nd Flolor FORT COLLINS CO 80522 This document was issued by the Liberty Mutual Insurance Group eCert onlllrl�G A Certincete System Like No Other U.S. Mail Document Sender: Heidi McLaughlin - MW ,'Phone: 800-392-9223 'Subject: Certification of Insurance Garvey Companies Inc Date: 9/19/2011 No. of Pages: 2 UR; www.LibertyMutual.com Please contact the sender above with insurance questions The attached or linked document(s) contains a Certificate of Insurance for the Insured named above. Your company is listed as the organization requesting receipt of this document(s). If this document(s) is sent via e-mail, you must click on the link below. The linked document(s) is in a pdf format, and you must have Adobe Acrobat Reader installed on your system. To download the Adobe Reader for free, visit www.Adobe.com. If you have any questions regarding the content of this message, please contact your local sales producer whose name and telephone number appears in the lower right hand corner of the attached Certificate. Click on the following link to retrieve and print the document(s) THIS MESSAGE IS INTENDED FOR THE USE OF THE INDIVIDUAL OR ENTITIY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. IF THE READER OF THE MESSAGE IS NOT THE ININTENDED RECIPIENT, OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING THE MESSAGE TO THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION, DISTRIBUTION OR COPYING OF THIS COMMUNICATION IS STRICTLY PROHIBITED. IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR, PLEASE NOTIFY US IMMEDIATELY BY TELEPHONE, AND RETURN THE ORIGINAL MESSAGE TO US AT THE ABOVE ADDRESS VIA REGULAR POSTAL SERVICE. www. eCertsOnt ine. com 0 2004Insurance Visions, inc. - www, insurancevisions. cont Certificate of Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFICATE HOLDER. THIS CERTIFICATE IS NOT AN INSURANCE POLICY AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. POLICY LIMITS ARE NO LESS THAN THOSE LISTED ALTHOUGH POLICIES MAY INCLUDE ADDITIONAL SUBLIMFULIMITS NOT LISTED BELOW. This is to Certify that Carney Companies Inc NAME AND Liberty 1333 NW Vivion Road ADDRESS OFINSURED Mutual® Kansas City MO 64118 is, at the issue date ofthis.anifiette, insured by the Conditions and is not altered by any requirement, Company under the policy(ies) listed below. The insurance afforded by the listed policy(ics) is subject to all their terns, exclusions and tern or condition of any contract or other document with respect to which this certificate may be Issued. EXP DATE TYPE OF POLICY ❑ CONTINUOUS ❑ EXTENDED POLICY NUMBER LIMIT OF LIABILITY ® POLICY TERM WORKERS 10/1 /2012 WA2-64D-426942-731 COVERAGE AFFORDED UNDER WC LAW OF THE FOLLOWING STATES: EMPLOYERS LIABILITY COMPENSATION AL,AR,AZ,CO,FL,GA,IA,KS,KY, MO,MS,NE,NM,OK,TN,TX,VA Bodily ln' .Oly Accidem 1000000Each Accident Bodily Injury By Disease 1 000 000 PcTic Bodily Injury By Disease 1 000 000 COMMERCIAL GENERAL LIABILITY 10/1/2012 TB2-641-426942-721 General Aggegate $2,000,000 Products / Completed Operations Aggregate ❑ OCCURRENCE 2 000 000 ❑ CLAIMS MADE Each Occurrence 10 Personal & Advertising Injury 1 OhhOO OOO Per Person/Organization RETRO DATE OTIp000,000 Fire Legal tye{0,000 Medical AUTOMOBILE LIABILITY 10/1 /2012 AS2-641-426942-711 Each Accident —Single Limit $2,000,000 B.I. And P.D. Combined r�I LJ OWNED Each Person Each Accident or Occurrence mNON -OWNED 0 HIRED Each Accident or Occurrence OTHER ADDITIONAL COMMENTS RE: Master Contract Ifthe cenificate expiration date is commuous or extended term, you will be notified ifemxrage is terminated or reduced before the certificate expiration date. Liberty Mutual NOTICE OF CANCELLATION. (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.) Insurance Group BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT C.INCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST bU DAYS NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO: RE: Master Contract sty of Fort Collins ,,(J Purchasing Division Laura Rudolph d P.O. Box 580 St. Loins / 0442 AUTHORIZED REPRESENTATIVE 12250 Weber Hill Road 215 North Mason Street, 2nd Flolor St. Louis MCI 63127 800-392-9223 9/19/2011 ort Collins CO 80522 I OFFICE PHONE DATE ISSUED This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those Companies NM 772 07-10 LDI COI 268896 02 11 AC401K%�e CERTIFICATE OF LIABILITY INSURANCE �/- 09/70/7011 O09/30 O011 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 1-816-421-7788 ArthurManagement J. Gallagher Risk Magement Services, Inc. CONTACTSusan McCaffrey NAME_Y _ WCNo, in 816-395-8694 ILL Noc 816-467-5694 2345 Grand Blvd., Suite 900 E-MML auean_alccnffra ADDRESS: yDaJq.c= _ INSURENS) AFFORDING COVERAGE NAICJ Kansas City, NO 64108 INSURER A: ST PAUL FIRS F NARIMB INS CO 24767 Tanner Burns _ _ INSURED Carney Molding Company / Garvey Companies, Inc. INSURER e: GSIDey Construction COmpmy, Inc. INSURER C: INSURER 0: Grin® Construction Company, Inc. 1333 NM Vivion Road Kansas City, NO 64118 INSURERE: INSURER F : COVERAGES CERTIFICATE NtIMRER- 23123235 - RFVISION NIIMRFR. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATPn..NOTWITHSTANDING ANY REQUIREMENT, TEEM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENI WIIH 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. INSfl ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER W MMIOD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ _ COMMERCM GENERAL UABILIFY _l 1 CLAIMS MADE 11 OCCUR DAMAGE TORENTE� PREMISES Eeoc m.. $ MED EXP (My are peam) $ PERSONAL a ADV INJURY $ GENERAL AGGREGA HE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $ POLICY PNU LOC S AUTOMOBILE LIAB4NY COMBINED SINGLE UNIT (Ea a enll BODILY INJURY (Pa Perm) S ANY AUTO ALL OWNED SCHEDULED AU AUTOS TOS BODIL(°f :Man1 Y INJURY P ae) $ NON,OWNEO HIRED NOS AUTOS PROPERTYDAMAGE Per arcWem $ $ A E OCCUR OKOBOO1360 10/01/1 10/01/12 EACHOCCURRENCE S 15, 000, 000 AGGREGATE $ 15, 000, 000 JXUMBRELLALIAB EXCESS DABI-I G1AM$-MADE DEO % I RF.TENiIONSNONB $ WORKERS COMPENSATION WC STATU- OTH- AMDEMPLOYERS' LUISILITY YIN ANYPROYRIEIORNARINERIEXECUIIVE OFFICERNEMBER EXCLUDED? ❑ N/A TORYJJfdlIS __ER_ EL EACH ACCIDENT $ EL.DISEASE-EAEMPLOYEE S (Msaamry In NH) Uuuaa aeXtlte uMw RIPrIONGFOPERNTION56elor E.L. DISEASE -POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES(AVac6 ACORD 101, AtlElBomd Ra m. Sch le. a mom rpaca it nqumo) Following Form Primary/Underlying Policies with Liberty Mutual Fire Insurance Company: General Liability including Completed Operations Policy iTB2-641-426942-721 Bff. 10-1-2011/10-1-2012 Auto Liability Policy MAS2-641-426947-711 off. 30-1-2011110-1-2012 Bolployers Liability/Workers' Compensation Policy eWA2-64D-426942-731 off. 10-1-2011/10-1-2012 Following Form Including Blanket Additional Insured, Primary and Non -Contributory and Blanket Waiver of Subrogation as required by written contract. Includes All Work and Operations Performed by insured covered by Primary/Underlying policies. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 300 Laporte Ave. AUTHORIZED REPRESENTATIVE Fort Collii USA no, CO 80522 I ---1 -- f)-"' // (O 19RR-2010 ACORD 2512010105) The ACORD name and logo are registered marks of ACORD micbor 23123235 All rinhte r,.a—A 0 ACOKOe CERTIFICATE OF LIABILITY INSURANCE , D09/20/2011ATE Y 09/20/2011 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(iss) 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 HBO of such endorsements . PRODUCER 1-816-421-7708 Arthur S. Gallagher Risk Namgament Services, Inc. CONTACT NAME: Susan McCaffrey .�yC-Hy". 816-395-8694 �L rum: 826-467-5694 2345 Grand Blvd., Suite 900 EIWL euam_mecaEfra ADDRESS: yYaJu.com INSURERf51 AFFORDWGCOVERAGE NAIC9 Kansas City, NO 6410E _ INSURER A: ST PAUL PIKE i MARINE INS CO 24767 Tamer Burns INSURED Gamey Bolding Company / Carney Companies, Inc. INSURER B Gamey Construction Company, Inc. INSURER C: INSURERD: Grim Construction Company, Inc. 1333 NW Vivion Road Kansas City, NO 64118 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 23123237 RFVICInN An Hu RFR. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWIFI STANDING ANY P.EQU:REMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER UUCUMENI 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. IL. NSR rypE OF INSURANCE ADDLSUBR POLN:YNUNBER MYLICYEFF uc EWYYYJ LIMITS GENERAL LIABILITY EACH OCCURRENCE S _ COMMEHCIAL GENERAL LABILITY DAMAGE TORENTEO PREMISES(Ea amurrmuD t MED EXP Ux, me Penn) t CLAIMS MADE D OCCUR PERSONAL B ADV INJURY f GENERAL AGGREGAI E t GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMPIOP AGO t O- POLICY VRLUC S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT -Laccidenl S BODILY INJURY (Pa peaml t ANY AUTO ALL OWNED SCHEDULED AUTOS AUTO $ BODILY INJURY P.etndan) IIl NON OWNED HIREDAUTOS AUTOS PROPERTY DAMAGE LPoouenl $ S A E UMBRELLA LIAR E OCCUR OK08001360 10/Ol/1 10/01/12 EACH OCCURRENCE S 15,000,000 AGGREGATE t 15,000,000 EXCESS LIM CLAIMS MADE DED I E RETENTION $ WORK t WORNERSCOMPENSATTON WC STAID- OTH- AND EMPLOYERS' LIABILITY YIN ANY PROPRIEIORIPARTNEHIE%ECUTIVE OFFICERIMEMUER EXCLUOE07 ❑ NIA BYUMITfl _Eft - EL. EACH ACCIDENT t _ E.L. DISEASE - EA EMPLOYE $ (Nandatdry In NH) A gas, deem6e mM DE SCRIP HIGH OF OPERATIONS Uabw EL. DISEASE -POLICY LIMIT t DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IAaach ACORD 101, Addlaonal Fh malls SchMYM, if men "ce Is r uludl Following Form Primary/Underlying Policies with Liberty Mutual Fire Insurance Company: General Liability including Completed Operations Policy aTB2-641-426942-721 Eff. 10-1-2011/10-1-2013 Auto Liability Policy AA82-641-426942-711 SEE. 30-1-2011/10-1-2012 Employere Liability/Workers• Compensation Policy RWA2-64D-426942-731 EEf. 10-1-2011/10-1-2012 Following Form Including Blanket Additional Insured, Primary and Non -Contributory and Blanket Waiver oE Subrogation as rewired by written contract. Includes All Work and Operations Performed by insured covered by Primary/Underlying policies. of Port Collins P.O. Box 580 Port Collins, CO 80522 ACORD 25 (2010105) micbor 23123237 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE (D1988-2010 ACORD CORPI The ACORD name and logo era registered marks of ACORD reserved. Lyl,tlxarexu S AC")?a 009E30/2 I11 ��. CERTIFICATE OF LIABILITY INSURANCE 09/2o/2ola 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(iss) 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 doer not confer rights to the certificate holder In lieu of such endorsements . PRODUCER 1-816-421-7788 Arthur J. Gallagher Risk NaOagement Services, —C. CONTACTSusan McCaffrey ey PHONE FOX LN0 N4. Ere. 816-395-8694 IgD Rot; 816-467-5694 2345 Grand Blvd., Suite 900 41 �pDORLSS. susa _jmccaffreyBajg.com INSURERISI AFFORDING COVERAGE HAIC4 Kansas City, NO 64108 INSURER A; ST PAUL FIRS E MARINK INS CO 24767 Tanner Burns INSURED Garrey Holding Company / Garrey Companies, Inc. INSURER S; Garrey construction Company, Inc. INSURER C: INSURER O: Gri® Construction Company, Inc. 1333 NW Vivian Road Kansas City, NO 64118 INSURER E: INSURER F : COVENAGtS CERTIFICATE NUMBER' 23123238 RFUISInN MIIMRFR. 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 10 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 TYPE OF INSURANCE AWL SUER POLICY EFF POLICY EXP LTR POLICY NUMBER M LIMITS GENERAL LIABILITY EACH OCCURRENCE 6 COMMERGAL GENERAL LUBILITY DAMAGE T(5RENTEO PREMISES Ee accvnexs) $ MED EXP (M me Pw^nR) S CUUMS-MADE ❑ OCCUR PERSONAL a ADV INJURY i GENERA -AGGREGATE S GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO S POLICY PRO- L00JFCT S AUTOMOBILE Lm81LTTY COMBINED SINGLE LIMIT Ea.'denl 3 BODILY INJURY IPa,xr n) S ANY AUTO _ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Peui t Per i S HIRED AUTOS NON OWNED AUTOS PROPERTY DAMAGE .Lacddenll S $ A Z OCCUR gR08001360 10/01/1 10/01/12 EACH OCCURRENCE 115,000,000 AGGREGAIE 9 15,000,000 JXUMBRELLAUAB EXCESS LIAR CLAIMS MADE OED X I RETENTION HONK S WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIE1tECUTIVE OFFICERIMEMBER E%ClUOEW ❑ NIA — 9flYLIMIT OR EL EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE S (Mmdmon In NH) If pas tleamlee umw DESCRIP I ION OF OPERATIONS Cob. El. DISEASE - POLICY LIMIT i DESCRIPTION OF OPERAMNS I LOCATIONS I VEHICLES ( W.h ACORD 101. AddlllonM R.r1u SchM W, N man wMu Is,puin4) Following Form primary/Underlying Policies with Liberty Mutual Fire Insurance Company: General Liability including Completed Operations Policy #TB2-641-426942-721 Elf. 10-1-2011/10-1-2012 Auto Liability Policy 4AS2-641-426942-711 off. 10-1-2011/10-1-2012 Employere Liability/Workers• Compensation Policy BWA2-64D-426942-731 Kff. 10-1-2011/10-1-2012 Following Form Including Blanket Additional Insured, Primary and Non -Contributory and Blanket waiver of Subrogation as required by written contract. Includes All Work and Operation. Performed by insured covered by Primary/Underlyiag policies. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE of Port Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. P.O. SO. 580 AUTHORIZED REPRESENTATIVE Fort C011ii USA no, CO 80522 I --- ) // 2179RR-2010 AOnRn CYIRPnRATIr1M ACORD 25 (2010/05) The ACORD name and Ingo are registered marks of ACORD micbor 23123238 ACOKL7a CERTIFICATE °ATE IMMIDYYY) ��. OF LIABILITY INSURANCE 09/20/2"011 09/70/21 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 endorsements . PRODUCER 1-816-421-7788 Arthur J. Gallagher Risk Nmngement 9nrvlcae, Iac. CO TA I NAME: $LLBAO McCaffrey PHONE 816-395-8694 I NC Ro; 816-467-5694 _WC E-MAIL euean alccaf Ere ADD SS: yQaJg.c= 2345 Orand Blvd., Suite 90U _ INSURERS) AFFORDING COVERAGE NAICI Kansas City, NO 64108 INSURER A: SIT PAUL FIRE 6 NARINB INS CO 24767 Tanner Burns _ INSURED Garrey HoldingCompany / Gamey companies, Inc. INSURER B: Construction Onsnetturu CCloa Company, Inc. W6URE. C: INSURERD: Grimm Construction ComyaRy, Inc. 1333 NW Vivlon Reed Kansas City, NO 64118 INSURERE: INSURER F : COVERAGES CERTIFICATE NUMBER: 23123239 REVISION NUMRFR- 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 DOCUMENTWITH 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. INS. OU TYPE OF INSURANCE LSUBR POLICY NUMBER MOLICYEFF PMIM YEXP LIMITS GENERAL LIABILITY EACHOCCURRENCEf COMMERCIAL GENERAL LIABILIry �CWMS MADE nOCCUR OAMAGESiEa EO PREMISEB Fs ocaxrenw f WED EXP IMYOre S PERSONAL S ADV INJURY f GENEHL AGGHEGAIE f L AGGREGATELIMIT APPLIES PER: PRODUCTS - COMPIOP AGG f 1 POLICY PRO- LOG f AUTOMOBILE UASIUTY COMBINED SINGLE LIMIT LEa amdentl f BODILY INJURY (Pw penml S ANY AUTO ALL OWNED F7 SCHEDULE° AUTOS AUTOS BODILY INJURY Per ecddmt ( I f NON OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Pa xcltlenl f f A Y UMBRELLA LMB E �G�y pE08001360 10/O1/1 10/01/12 EACHOCCURRENCE $15,000,000 AGGHEGAIE $ 15, 000, 000 E1lCESS UJU3 CIAIMS-MADE DELI E RETEMION NONB f WORMERS COMPENSATION WC STATU. OTH- ANDEMPLOYERS' LIABILITY YIN ANY PROPRIE IOWPARINEWE%ECUTNE OFFICEWMEMBER EXCLUDED? ❑ NIA -1D13YLW1TS _LEL EL. EACH ACCIDENT S E.L. DISEASEEAEMPLOYE $ (MamMory In NH) It yap da N, UMw DESCRIPTION OF OPERAHONS 6elUw E.L. DISEASE -POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS IVEHICLES (AWch ACORD 101, Additnal Ramada SrAaduw, N moa apaw isr uiM) Following Porn Primary/Underlying Policies with Liberty Mutual Fire Insurance Company: General Liability including Completed Otforationa Policy NT'B2-641-426942-721 aft. 10-1-2011/10-1-2013 Auto Liability Policy AAS2-641-426942-711 Eff. 10-1-2011/1D-1-2012 Rmployera Liability/Workers• Compenestion Policy awk2-64D-426942-731 BEE. 10-1-2011/10-1-2012 Following Porn including Blanket Additional Insured, Primary and Mon -Contributory and Blanket Waiver of Subrogation an required by written contract. Includes All Work and Operations Performed by insured covered by Primary/Underlying policies. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE of Fort Collin THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Do. 580 AMORIIED REPRESENTATIVE p Fort C011inR, CO 80522 --I- 1)"�! USA1 // ACORD CORPORATION. All rights ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD mfcbor 23123239 YE N,UtXU'IE ACOKOe °0ATE (MWDONYYYI ✓� CERTIFICATE OF LIABILITY INSURANCE 09 /20/7011 9/20 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(iss) 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 endorsements . PRODUCER 1-816-121-7788 Arthur J. Gallagher Risk Managament services, Inc. CONTANAME Susan Susan McCaffrey - PHONE .816-395-8694 NC N0; 616-467-5694 2345 Grand Blvd., suite 900 EJIAIL cucea_mccaEfre ADDRESS: ysajg.Com INSURER(S)AFFORDING COVERAGE NAIC9 RanBas City, NO 64108 INSURER A: ST PAUI. PIRG i MARINE INS CO 24767 Tanner Burns INSURED Bney Bolding Company / Carney COMpIInlea, Inc. INSURER B BarneyeCOnatrLLCtiOa Company, Inc. INSURERC: INSURER D: Grirma Construction Company, Inc. 1333 NW Vivion Road Renee City, NO 64118 INSURER E: INSURER F: COVERAGEN CERTIFICATE NtIMRFR' 23123231 RFVISNIN MIIFRRFR. 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, TERN! OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WRH 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 TYPE OF INSURANCE ADOL SUBR ICYEXP LIR POLICY NUMBER M /DDYEFF PM'LIMITS GENERAL UASILGY EACH OCCURRENCE T COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES(Ea ocart I $ MED EXP (My omyendn1 S CINMS MADE ❑ OCCUR PERSONAL S AOV INJURY $ GENERAL AGGREGATE 1 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMNOP AGO $ POLICY D PBP LOC $ AUTOMOBILE LLUMUTY COMBINED SINGLE LIMIT IEa alcdanll BODILY INJURY P. N.) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AU10-05 BODILY INJURY(PwammUrl) I WN HIRED AUTOS NONED _ AUTOS PROPERTY DLnl AMAGE -accpe $ E A X UMBRELLALUB X OCCUR OKOBOD1360 10/01/1 10/01/12 EACHOCCURRENCE 115,000,000 AGGREGATE f 15, 000, 000 EXCESS LIAR CLAIMS MADE DED A RETENTION NONE $ WORKERS COMPENSATION WC STATU- OTN- AND EMPLOYERS' LIABILITY YIN ANY PROPRIE I ONPARTNERIEXECU THE OFFICERIMEMBER EXCWDE07 ❑ NIA —SORY.LN8T5. E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE S (Yaada mNH) If yas deaaiEeuMw DESCRIPTION OF OPERATIONS bet E.I. DISEASE -POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AA&O ACORD 101, AddlaonM Ramada SmWuM, If man aW a is rpultM) Following Form Primary/Underlying Policies with Liberty Mutual Fire Insurance Company: General Liability including Completed Operations Policy 1ITB2-641-426942-721 Off. 10-1-2011/10-1-2012 Auto Liability Policy #M2-641-426942-711 Off. 10-1-2011/10-1-2012 Employers Liability/Workers• Cospeneation Policy aWA2-64D-426942-731 Off. 10-1-2011/10-1-2012 Following Form Including Blanket Additional Insured, Primary sad Non -Contributory and Blanket Waiver of Subrogation as required by written contract. Includes All Work and Operations Performed by insured covered by Primary/Underlying policies. I.ANL ItLLAI IVN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins, Colorado THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO Boa 580 AUTHORREU REPRESENTATIVE p Fort Collins, CO 80522 T✓ 1)-'� U8A 1 / m 1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD micbor 23123231 a ry z w Acilcme oe CERTIFICATE °A9/ OF LIABILITY INSURANCE 09/IMMIDW 20/2010/701Y) 1 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 endorsemenl(s). PRODUCER 1-816-411-]]88 Arthur J. Gallagher Risk Management Services, Inc. CONTACT NAMESusan McCaffrey PHONE €U: 816-395-8694 Iljt 816-467-5694 2345 Grand Blvd., Suite 900 EWUL euenn_uN;caffra com ADDRESS yMajig- INSURERS) AFFOROUIG COVERAGE NAILS AaneaB City, RO 64108 INSURER A: ST PAUL PIPE fi MARIRB INS CO 24767 Tanner Burns_ _ INSURED Garrey Holding Company / Carney Companies, Inc. INSURER B: Gamey COIIBtnCtiOn COalpany, Inc. INSURER C: INSURER D: Gri. Construction Company, Inc. 1333 NN Vivlon Road Kansas City, NO 64118 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: 23123233 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 CONTRACTOR OTHER DOCUMGNi WIN 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. INSP TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP POLICY NUMBER MMAHNYYYYI (MIMBDOMWI I LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABIUIY DAMAGE TO RENTED PREMISESWRENTEIJ ol_ S MEDEXPAMyarepenpn) S _I CLAIMS MADE 11 OCCUR PERSONAL a ADV INJURY S GENERALAGGREGAIE t COIL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG f POLICY � LUC � f AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT .(L..,dam BODILY INJURY(Pw penv) t ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Ps eGYrMI ( I t AUTOWNED HIREDAUTOS AUTOS PROPERTY DAMAGE LPPA.W.nf S f A A UMBRELLAUAB X OCCUR OKOSOO1360 10/01/1 10/01/12 EACH OCCURRENCE f 15,000,000 AGGREGATE t15,000,000 EXCESS LAB CLAIMS MADE DED I X I RETENTION S NONE S WORMERS COMPENSATION WC STATU- OTH AND EMPLOYERS' LABILITY YIN ANY PROPRIE I ORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUOEO7 ❑ NIA TG8YLI1BI3 EB_ E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE f (Mandalory In NM) If ye d.MIx UMa DE SCRIPTIONOFOPERATIONSCubw E.LDISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AIMLN ACORD 101. AddlBonal Remarks SCNtluN, H mpn apau b,pui,ad) Following Form Primary/Underlying Policies with Liberty Mutual Fire Insurance Company: General Liability including Completed Operations Policy BTE2-641-426942-771 Eff. 10-1-2011/10-1-2012 Auto Liability Policy 4AS2-641-426942-711 Eff. 10-1-2011/10-1-2012 Employers Liability/WOrkeret Comaensatlon Policy 8wA2-64D-426942-731 Eff. 10-1-3011/10-1-2012 Following Form Including Blanket Additional Insured, Primary and Non -Contributory and Blanket waiver of Subropatlon as reQuired by written contract. Includes All Work and Operations Performed by insured covered by Primary/Underlying policies. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE of Fort Collins, Colorado THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 580 AUTNORMED REPRESENTATIVE Q Fort Collins, CO 80522 1_ I%-^� USA // ACORD 25 (2610/05) micbor 23123233 01988-2010 ACORD CORPORATION. All dahte The ACORD name and logo are registered marks of ACORD r— CERTIFICATE - ADDENDUM Garvey Construction 7911 Shaffer Parkway Littleton CO 80127 City of Fort Collins, Colorado PO Box 580 Fort Collins CO 80522 RE: Canal Importation Ponds and Outfall - Work Order #11 - Fairbrook Pond Landscaping. City of Fort Collins, Colorado, Anderson Consulting Engineers and Ayres Associates are an additional insured under the General Liability and Automobile Liability policy if required by written contract with the Named Insured, but only for the coverage and limits provided by the policy and the additional insured endorsement. Created at www.eCert-sdNL1NE.com Certificate of Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFICA'E HOLDER. THIS CERTIFICATE IS NOT AN INSURANCE POLICY AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. POLICY LIMITS ARE NO LESS THAN THOSE LISTED, ALTHOUGH POLICIES MAY INCLUDE ADDITIONAL SUBLIMIT/LIMITS NOT LISTED BELOW. This is to Certify that Carney Construction NAME AND •'• Liberty 7911 Shaffer Parkway ADDRESS OF INSURED Mutual® Littleton CO 80127 is, at the issue date ofthis certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ies) is subject to all their terms, exclusions and Conditions and is not altered by am remuirement. term or condition ofany contractor other document with respect to which this cenificate maybe issued. EXP DATE TYPE OF POLICY ❑ CONTINUOUS ❑ EXTENDED POLICY NUMBER LIMIT OF LIABILITY ® POLICY TERM WORKERS COMPENSATION 10/1 /2012 WA2-64D-426942-731 COVERAGE AFFORDED UNDER WC LAW OF THE FOLLOWING STATES: AL,AR,AZ,CO,FL,GA,IA,KS, KY, MO,MS,NE,NM,OK,TN,TX,VA EMPLOYERS LIABILITY Bodily lrfnryby Accident 1000000 Each Accident Bodily Injury By Disease 1 000 000 Bodily Injury By Disease 1 000 000 COMMERCIAL. GENERAL LIABILITY 10/1/2012 TB2-641-426942-721 General Aggregate $2,000,000 Products /Completed Operations Aggregate ❑ OCCURRENCE 2 000 000 ❑ CLAIMS MADE Each Occurrence $1,000,000 Personal & Advertising Injury . 1 000 000 Per Person/Organization RETRO DATE Dtt�h5yd00,000 Fire Legal V0,000 Medical AUTOMOBILE LIABILITY 10/1/2012 AS2-641 426942-711 Each Accident —Single Limit $2,000,000 B.I. And P.D. Combined t�1 LJ OWNED Each Person Each Accident or Occurrence NON -OWNED r❑ LJ HIRED Each Accident or Occurrence OTHER ADDITIONAL COMMENTS See Addendum Attached. Ifthe cenificate expiration date is continuous or extended term, you will be notified ifcoverage is terminated or reduced before the certificate expiration date. NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.) BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST 60 DAYS NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO: Re:Work Order #13-Canal Importation Ponds/Outfall F -city of Fort Collins ems` c3 P.O. Box 580 Lort Collins CO 80522 J Liberty Mutual Insurance Group Laura Rudolph St. Louis 10442 AUTHORIZED REPRESENTATIVE 12250 Weber Hill Road St. Louis MO 63127 800-392-9223 9/19/2011 OFFICE PHONE DATE ISSUED This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those Companies NM 772 07-10 LDI COI 268896 02 11 CERTIFICATE - ADDENDUM NAMED INSURED CERTIFICATE HOLDER 9/19/2011 Garvey Construction City of Fort Collins 7911 Shaffer Parkway P.O. Box 580 Littleton CO 80127 Fort Collins CO 80522 RE: Canal Importation Ponds and Outfall — Work Order #13 — 2010 Construction Activities. Site of the work is located approximately at the intersection of Prospect Road and Taft Hill Road, Fort Collins, Colorado as shown on the Drawings. Site is in the Canal Importation Basin in west central Fort Collins, Colorado. City of Fort Collins, Anderson Consulting Engineers and Ayres Associates are additional insured under the General Liability policy if required by a written contract with the Named Insured, but only for the coverage and limits provided by the policy and the additional insured endorsement. Created at www.eCertsONLINE.com �' , +, � ;,�.� IV-AD2,(2002) Certificate of Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFICATE HOLDER. THIS CERTIFICATE IS NOT AN INSURANCE POLICY AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. POLICY LIMITS ARE NO LESS THAN THOSE LISTED ALTHOUGH POLICIES MAY INCLUDE ADDITIONAL SUBLIMIT/LIMITS NOT LISTED BELOW. This is to Certify that Garvey Construction NAME10 7911 Shaffer Parkway ADDRESSD Liberty OF INSURED Mutual® Littleton CO 80127 is, at the issue date of this certificate, insured by the Company under the policy(les) listed below. The insurance afforded by the listed policy(ics) is subject to all their terns, exclusions and Conditions and is not altered by any requirement, tern or condition of any contract or other document with respect to which this cenificatc maybe issued. EXP DATE TYPE OF POLICY ❑ CONTINUOUS []EXTENDED POLICY NUMBER LIMIT OF LIABILITY ® POLICY TERM WORKERS COMPENSATION 10/1/2012 WA2-64D-426942-731 COVERAGE AFFORDED UNDER WC LAW OF THE FOLLOWING STATES: AL,AR,AZ,CO,FL,GA,IA,KS,KY, MO,MS,NE,NM,OK,TN,TX,VA EMPLOYERS LIABILITY Bodily ln'ury by Accident 1000000EachAceidert Bodily Injury By Disease 1 000 000 Bodily Injury By Disease 1 000 000 COMMERCIAL GENERAL LIABILITY 10/1/2012 TB2-641-426942-721 General Aggregate $2,000,000 Products / Completed Operations Aggregate ❑ OCCURRENCE 2 000 000 ❑ CLAIMS MADE Each Occurrence $1,000,000 Personal & Advertising Injury . 1 OhhOO OOO Per Person / Organization RETRO DATE 'T 00,000 Fire Legal fr10,000 Medical AUTOMOBILE LIABILITY 10/1/2012 AS2-641-426942-711 Each AccidentCoSingle Limit $2,000,000 B.I. And P.D. Combined I�1 LJ OWNED Each Person Each Accident or Occurrence NON -OWNED rm l•J HIRED Each Accident or Occurrence OTHER ADDITIONAL COMMENTS RE: North College Sanitary Sewer Manhole Replacement. City of Fort Collins is an additional insured under the General Liability policy if required by a written contract with the Named Insured, but only for the coverage and limits provided by the policy and the additional insured endorsement. Ifthe certificate expiration date is continuous or extended term, you will be notified ifcovemgc is terminated or reduced before the certificate expiration date. NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.) BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST 60 DAYS NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO: RE: North College Sanitary Sewer Manhole Rpl. FQty of Fort Collins t e P.O. Box 580 Lort Collins CO 80522 J Liberty Mutual Insurance Group &) s �- (i Laura Rudolph St. Louis / 0442 AUTHORIZED REPRESENTATIVE 12250 Weber Hill Road St. Louis MO 63127 800-392-9223 9/19/2011 OFFICE PHONE DATE ISSUED This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those Companies NM 772 07-10 LDI COI 268896 02 11 Certificate of Insurance THIS CERTIFICATE. IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFICAE HOLDER. THIS CERTIFICATE IS NOT AN INSURANCE POLICY AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. POLICY LIMITS ARE NO LESS THAN THOSE LISTED ALTHOUGH POLICIES MAY INCLUDE ADDITIONAL SUBLIMIT/LIMITS NOT LISTED BELOW. This is to Certify that Garney Construction � Li� NAME AND berty 7911 Shaffer Parkway ADDRESS OF INSURED Mutual® Littleton CO 80127 is, at the issue date ofthis certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ies) is subject to all their terms, exclusions and Conditions and is not altered by anv remui¢ment. term or condition of am, contract or other document with respect to which this certificate may be issued. EXP DATE TYPE OF POLICY ❑ CONTINUOUS ❑ EXTENDED POLICY NUMBER LIMIT OF LIABILITY ® POLICY TERM WORKERS 10/1/2012 WA2-64D-426942-731 COVERAGE AFFORDED UNDER WC LAW OF THE FOLLOWING STATES, EMPLOYERS LIABILITY COMPENSATION AL,AR,AZ,CO,FL,GA,IA,KS,KY, MO,MS,NE,NM,OK,TN,TX,VA Bodily lnuryby Aecidem 1 000000 each Accident Bodily Injury By Disease 1 000 000 Pat Bodily Injury By Disease 1 000 000 COMMERCIAL GENERAL LIABILITY 10/1/2012 TB2-641-426942-721 General Aggregate $2,000,000 Products /Completed Operations Aggregate ❑ OCCURRENCE 2 00,000 ❑ CLAIMS MADE Each Occurrence RETRO DATE Personal & Advertising Injury . 1 OOO OOO Per Person/Organizauon OTY00,000 Fire Legal ,Vo,o00 Medical AUTOMOBILE LIABILITY 10/1/2012 AS2-641-426942-711 Each Accident —Single Limit $2,000,000 B.I. And P.D, Combined t�I LJ OWNED Each Person Each Accident or Occurrence mNON -OWNED HIRED Each Accident or Occurrence OTHER ADDITIONAL COMMENTS City of Fort Collins, Colorado is an additional insured under the General Liability and Automobile Liability policy if required by written contract with the Named Insured, but only for the coverage and limits provided by the policy and the additional insured endorsement. Ifthe certificate expiration date is continuous or extended term, you will be notified ifcovemge is terminated or reduced before the certificate expiation date. Liberty Mutual NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW) Insurance Group BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT CHANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST 68 DAYS NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO: Right of Way License Fity of Fort Collins C�'Cl �v`Cz�L� ®(� Laura Rudolph St. Louis / 0442 AUTHORIZED REPRESENTATIVE 12250 Weber Hill Road P.O. BOX 580 St. Louis MO 63127 800-392-9223 9/19/2011 Fort Collins CO 80522 I OFFICE PHONE DATE ISSUED This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those Companies NM 772 07-10 LDI COI 268896 02 11 Certificate of Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFICNE HOLDER. THIS CERTIFICATE IS NOT AN INSURANCE POLICY AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. POLICY LIMITS ARE NO LESS THAN THOSE LISTED ALTHOUGH POLICIES MAY INCLUDE ADDITIONAL SUBLIMIT/LIMITS NOT LISTED BELOW. This is to Certify that Garney Construction NAME AND t'� Liberty 7911 Shaffer Parkway ADDRESS O® Littleton CO 80127 OFINSURED Mutual® is, al the issue date of this certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed Wlicy(ies) is subject to all their terms, exclusions and Conditions and is not altered by env repuaement. term orconditirn ofanv contract or other document with respect to which this certificate noy be issued. EXP DATE TYPE OF POLICY ❑ CONTINUOUS ❑ EXTENDED POLICY NUMBER LIMIT OF LIABILITY ® POLICY TERM WORKERS COMPENSATION 10/1/2012 WA2-64D-426942-731 COVERAGE AFFORDED UNDER WE LAW OF THE FOLLOWING STATES: AL,AR,AZ,CO,FL,GA,IA,KS,KY, MO,MS,NE,NM,OK,TN,TX,VA EMPLOYERS LIABILITY Bodily ln' by Accidem 1000000 each A—&.t Bodily Injury By Disease 1000 000 NI Bodily Injury By Disease 1 000 000 COMMERCIAL GENERAL LIABILITY 10/1/2012 TB2-641-426942-721 General Aggregate $2,000,000 Products /Completed Operations Aggregate ❑ OCCURRENCE 2 O00 000 ❑ CLAIMS MADE Each Occurrence 1 Personal & Advertising Injury 1 OOO OOO Per Person / Organiaetron RETRO DATE t� Gbr100,000 Fire Legal V10,000 Medical AUTOMOBILE LIABILITY 10/1/2012 AS2-641-426942-711 Each Accident —Single Limit $2,000,000 R.I. And P.D. Combined t�I LJ OWNED Each Person Each Accident or Occurrence mNON -OWNED 0 HIRED Each Accident or Occurrence OTHER ADDITIONAL. COMMENTS See Addendum Attached. Ifthe certificate expiration date is continuous or extended term, you will be notified ifcoverage is terroinated or reduced before the certificate expiration date. NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.) BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT CA8CEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST 6DAYS NOTICE OF SUCH. CANCELLATION HAS BEEN MAILED TO: Re: Canal Importation Ponds/Outfall-Work Order 12 sty of Fort Collins, Colorado =s x PO Box 580 Fort Collins CO 80522 Liberty Mutual Insurance Group Laura Rudolph St. Louis 10442 AUTHORIZED REPRESENTATIVE 12250 Weber Hill Road St. Louis MO 63127 800-392-9223 9/19/2011 OFFICE PHONE DATE ISSUED This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those Companies NM 772 07-10 LDI COI 268896 02 11 CERTIFICATE -ADDENDUM NAMED INSURED CERTIFICATE HOLDER 9/19/2011 Garvey Construction City of Fort Collins, Colorado 7911 Shaffer Parkway PO Box 580 Littleton CO 80127 Fort Collins CO 80522 RE: Canal Importation Ponds and Outfall - Work Order #12 - Red Fox Meadows Pond Landscaping. City of Fort Collins, Colorado, Anderson Consulting Engineers and Ayres Associates are an additional insured under the General Liability and Automobile Liability policy if required by written contract with the Named Insured, but only for the coverage and limits provided by the policy and the additional insured endorsement. i I I Created at www.eCertsONLINE.com - i IV-AD2 (2002) f .• r, i Liberty Mutual 12250 Weber Hill Road St. Louis MO 63127 City of Fort Collins Purchasing Division P.O. Box 580 215 North Mason Street, 2nd Flolor FORT COLLINS CO 80522 This document was issued by the Liberty Mutual Insurance Group eCertsOnl%ne1j A Certificate System Like No Other U.S. Mail Document Sender: Heidi McLaughlin -MW Phoger' 800-392-9223 Subject: Certification of Insurance Gamey Companies Inc Date: 9/19/2011 No. of Pages: 2 'LIRL: www.LibertyMutual.com Please contact the sender above with insurance questions The attached or linked document(s) contains a Certificate of Insurance for the Insured named above. Your company is listed as the organization requesting receipt of this document(s). If this document(s) is sent via e-mail, you must click on the link below. The linked document(s) is in a pdf format, and you must have Adobe Acrobat Reader installed on your system. To download the Adobe Reader for free, visit www.Adobe.com. If you have any questions regarding the content of this message, please contact your local sales producer whose name and telephone number appears in the lower right hand corner of the attached Certificate. Click on the following link to retrieve and print the document(s) THIS MESSAGE IS INTENDED FOR THE USE OF THE INDIVIDUAL OR ENTITIY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT 15 PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. IF THE READER OF THE MESSAGE IS NOT THE ININTENOEU RECIPIENT, OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING THE MESSAGE TO THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION, DISTRIBUTION OR COPYING OF THIS COMMUNICATION IS STRICTLY PROHIBITED. 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