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HomeMy WebLinkAbout166269 GARNEY CO INC - INSURANCE CERTIFICATE (5)P52W2B1✓J2 ACbRoM DATE CERTIFICATE OF LIABILITY INSURANCE 09/20/s011ID o9/aou 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 pollcies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 1-816-421-77811 Arthur J. Gallagher Risk Manageeent Services, Inc. CONTACT ?aeon McCaffrey NAME: Y — PHONE a IC No, Eaq:_Blfi-395-8694 _ _(AJC No): 816-467-5694, E-MAIL fre m ADDRES£__euenn mccaf--__ YBajg•co 2345 Grand Blvd., Suite 900 _-- INSURER(S) AFFORDING COVERAGE NAIL/ Kaneas City, NO 64108 INSURER A: ST PAUL FIRE 4 MARINS INS CO 24767 Tanner Burns _ INSURED Garrey Bolding Company / Gamey Companies, Inc. Gamey Conatr ction Company, Inc. INSURER 9: INSURER C: INSURER D: Grimm Construction Company, Inc. 1333 MW Vivion Road Kansas City, NO 64118 INSURER E: INSURER I: COVERAGES CERTIFICATE NUMBER- 23123234 REVISION NUMBER - THIS IS ,TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW H.AVE.SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERI00 - INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 ILTR TYPE OF INSURANCE iA00L�SUBR MMID W4, MI OIYYYY . LIMITS POLICY NUMBER GENERAL LIABILITY EACH OCCURRENCE $ _ COMMERCIAL GENERAL LWBIUTY �CLAIMS MADE 0 OCCUR DAMAGE TO RENTED PREMISESLEaattunence)_ NED EXP(My me Person) S $ PERSONAL S ADV INJURY S GENERAL AGGREGATE S GENL AGGREGATE LIMIT APPLIES PER'. PRODUCTS-COMNOPAGG S POLICY 17 PRO- LOC S AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT .lEa acaden0__ j I S ANY AUTO BODILY INJURY(Per. person) ALL OWNED SCHEDULED UTOSN"'WNED BODILY INJURY(Per Scorner f =AUTOS HIRED AD AUTOS - `PROPERTY DAMAGE .cHenr S — S I& A IY UYBRELU LIAR 8 OCCUR OKOBOO1360 10/Ol/11 10/Ol/12 EACHOCCURRENCE $15,000,000 EXCESS L AB C wIMS MAp AGGREGATE $ 15, 000, 000 I-1 DED Y RETENTIONSNONE f WORKERS COMPENSATION AND EMPLOYERS'LLSBILfT1' YIN ANYPROPRIETOPoPPRTNEPoEXECUTIVE❑ WC BTATLL OT14 YLIMITSI_I_ER-I EL EACH ACCIDENT S OFFICERMEMBER EXCLUDED? NIA EL DISEASE -EA EMPLOYE $ (Mandator, In NN) DESCRIPTION OF OPERATIONS Uebw E.L. DISEASE - POLICY LIMIT f DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more span is reRuired) Following Form Primary/Underlying Policies with Liberty Mutual Fire Insurance Company: General Liability including Completed Operations Policy #TB2-641-426942-721 Eff. 10-1-2011/10-1-2012 Auto Liability Policy BAS2-641-426942-711 Eff. 10-1-2011/10-1-2012 Employers Liability/Workers' COVlpensation Policy IIWA2-64D-426942-731 Eff. 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. City of Fort Collins P.O. Box 580 ' Atm: Purchasing Division 215 North Mason Street, 2nd Plolor Fort Collins, CO 80522 ACORD 25 (2010106) Mich= 23123234 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 �ri ri USA �) ` ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD F—P5MW2.2 ''� o® °09/20/O°11 CERTIFICATE OF LIABILITY INSURANCE o9/zo/sou 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 Arthur G. Gallagher Risk Management Services, Inc. CONTACT Susan McCaffrey PHONE FAX INC, No, E.q:816_395-8694 —TAT ,CG NoI_816-467-5694 — 2345 Grand Blvd., Suite 900 EMAIL ADDRESS 9uean_mccaffreyliajg.com ____,INSURER(SI AFFORDING COVERAGE _ NNCS Kansas City, NO 64108 INSURER A: ST PAUL FIRE S MARINE INS CO 24767 Tanner Burns_ _ INSURED Garrey Holding Company / Garrey Companies, Inc. INSURER B ---- Garvey Construction Company, Inc. INSURER C: INSURER D: Grimm Construction Company, Inc. N Road NW ViviCity, Kansas CLty, NO 64118 Kansas _ INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 23123236 REVISION NUMBER: THIS IS TO CERTIFYTHAT`THE-POLICIES -OFINSURANCE LISTED BELOW HAVE BEEN-!SSUED 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. INTR TYPE OF INSURANCE ADDL'iSUBRi ppDCY NUMBER MOLICYYFY �MMLill EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE S AL _ COMMERCIALGENERLIABILITY CLAIMS -MADE nOCCUR DAMAGE TOI RENu0n — REMIES Eaocerron PREMISES MEOEXP(Anyme Person) $ _ S PERSONAL S AUV INJURY $ GENERAL AGGREGATE IS GE IPOLIGAGGREGATE _ LIMIT APPLIES POECR: PRODUCTS - COMPIOP AGG I $ ll JFCT PRO- Ij�l I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT LEa_ecodenJ)_ - $ _ $ ANYAUTO 1 BODILY INJURY (Per Person) ALL OWNED SCHEDULED J INJURY (Per ambenl) $ MREAUTOD AUTOS �AUTOSWNED PROPERTY ICPeraaNen_2tDAMAGE I$ A OCCUR OK08001360 10/O1/11 10/01/12I EACHOCCURRENCE S 15, 000, 000 AGGREGATE $ Ij1 kjUMBRELLALUB EXCESS MAIL CLAIMSMAOE _5,000,000 DED % RETENTION S MOM $ WORXER3COMPENSATION WC STATU- OTH- AND EMPLOYERS'E000UTY YIN ANY PROPRIETORIPARTNERIEXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? NIA TORYLIMITS. $ _ _ER E L. EACH ACCIDENT -- E.L. DISEASE - EA EMPLOYE - $ INIeulmoryinNH) IT yes, deun'be uMer DESCRIPTION OF OPERATIONS bekw E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Amach ACORD 101, Add6dnal Ramada Scheduis, d mom apace la n9ui2M) Following Form Primary/Underlying Policies with Liberty Mutual Fire Insurance Company: General Liability including Completed Operations Policy NTB2-641-426942-721 Eff. 10-1-2011/10-1-2012 Auto Liability Policy B)LS2-641-426942-711 Eff, 10-1-2011/10-1-2012 Employers Liability/Workers- Compensation Policy aWA2-64D-426942-731 Eff. 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. City of Fort Collins P.O. Box 580 Attn: Purchasing Division 215 North Mason Street, tad Flolor Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE MTN THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 08A T) 011911E-2010 ACORn CORPI All rinhfa rAmrvod ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD micbor 23123236