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HomeMy WebLinkAbout101137 PINKARD CONSTRUCTION - INSURANCE CERTIFICATEa� I ®
CERTIFICATE OF LIABILITY INSURANCE
U10/10/so11ATE I°DI
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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 endorsement(s).
PRODUCER 1-303-534-4567
CONTACT
INA of Colorado, Inc.
PHONE FAX
IC, No, E.tp No):
E-MAIL
ADDRESS:
1550 17th Street
Suite 600
Denver, CO 80202--INSURER(S)
AFFORDING COVERAGE
NAIC4
INSURER A: ZURICH ANER INS CO
16535
_^
INSURED— 1�`1
INSURERS: NATIONAL UNION PIRS INS CO OP PITTS
19495
Pinkard Construction
INSURER c: PINNACOL ASSOR
141190
9195 West 6th Avenue
INSURER D:
Lakewood, CO 80215
INSURERE:_
INSURER F
COVFRAGFS CERTIFICATE NUMBER- 23565251 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.
ILA TYPEDFINSURANCE IfA00LISUBR POLICY NUMBER I MMIODOUCIYYYt�M1IC
001YYYY LIMITS
A
IGENERAL LIABILITY
X
rr COMMERCINI GENERAL LIABILITY
CLNMS-MADE L� OCCUR
X $5,000 Deductible
OW931935600
11/01/11
11/01/12
EACHOCCURRENCE
DAMAGE TO RENTED
-PREMISES owune9cej_
NED EXP(My we parson)_
PERSONAL A ADV INJURY
11, 000, 000
$ 300, 000
$ 5.000
$ 1, 000, 000
—
GENERAL AGGREGATE
$ 2,000,000
GENT AGGREGATE
POLICY
LIMIT APPLIES PER:
PRO- LOC
X I IFCT
PRODUCTS - COMPIOP AGG
$2,000,000
$
A
I AUTOMOBILE LIABILITY
�IANYAUT
AUTOS NED 1 SCHEDULED
L UTOS
II NON OWNED
HIREDAUTOS FX AUTOS
BAP931935500
COMBINED SINGLE LIMIT
(Ea acaoem) __
BODILY INJURY (Pa Person)
$. 1, 000,000
S
BODILY INJURY (Pca¢idenl)
$
PROPERTY DAMAGE
(PeraecXKnlL
$
Is
B
X
UMBRELLA LIAB
EXCESS LIAR
X�
OCCUR
CLAIMS MADE
BE23465094
it/O1/1
11/01/12
EACH OCCURRENCE
S 10,000,000
AGGREGATE
$ 10,000,000
—DE.7X7 RETENTION310,000
$
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITYYIN
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICERNEMSER EXCLUDED? N
IMandatory In NH)
If yes, describe uMer
DESCRIPTION OF OPERATIONS below
NIA
2321400
10/01/1
30/Ol/12
X WC STATU- IIOTH-
—.?ORYLIMIT3 —1_ER
EL EACH ACCIDENT
$ 500, 000
- —
E L DISEASE - EA EMPLOYES
- -
$ 500, 000
E.L. DISEASE - POLICY LIMIT
� -
$ 500, 000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AUech ACORD 101, Additional Ramwka 30aduM, 11 mon space la ra9ui,ed)
Certificate Holder is included as Additional Insured on the General Liability Policy if required by written contract or
agreement and with respect to work performed by Insured subject to the policy terms and conditions. A Waiver of
Holder on the General Liability and Workers Compensation Policies, if returied by written contract or agreement subject
to the policy terms and conditions.
conditions.
l,/ .be I- 1.Ivn
HE: Work Order# H-WRF.
2004-1 Daft Odor Control. - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
300 Went La Porte Ave. AUTHORIZED REPRESENTATIVE
P.O. Box 580 / A
Fort Collins, CO 80522
I USA
©1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
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23565251
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