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250056 WYATT CONSTRUCTION CO INC - INSURANCE CERTIFICATE
Al V® CERTIFICATE OF LIABILITY INSURANCE 5/7/2a12YYY' 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(les) 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 endomement(s). PRODUCER Co West Insurance Associates P.O. BOX 101387 Denver CO 80250-1387 CONTACT COWest Associates NAME: PNONE (720) 5 2 4 - 9 3 4 4 FAXINC . (720)524-9352 Ar -L EMAI SS INSURERS AFFORDING COVERAGE NAIC If INSURER APinnacol Assurance 41190 INSURED `V Wyatt Construction Co.Inc. �./� 3223 Arapahoe Avenue #100 Boulder CO 80303 INSURER B INSURER C: INSURER D: 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 A POLICY NUMBER DPOLICY MMDDNYYy POLICY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ -ffAMA NTE COMMERCIAL GENERAL LIABILITY PR a u,mroo $ CLAIMS -MADE ❑ OCCUR MED EXP (Any one arson) $ PERSONAL It ADV INJURY $ GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ $ POLICY PRO LOD AUTOMOBILE LIABILITY C0M INED SINGLE LIMIT nt Ea accide BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Peraccidm $ NON -OWNED HIRED AUTOS HAUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTIONS I $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N 4115005 5/1/2012 5/1/2013 X WC STATU- OTH- AN'( PROPRIETOWPARTNER/EXECUTIVE — OFFICER/MEMBER EXCLUDED? u N/A E.L. EACH ACCIDENT $ 1 000 000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ 1, 000, 000 If yes, describe under DESCRIPTION OF OPERATIONS below E. L. DISEASE -POLICY LIMIT I $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace is required) City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 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 ACORD 25 (2010/05) INS025 (201005)_01 .R. Withrow/AMB ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD �`� �® -CERTIFICATE OF LIABILITY INSURANCE 5/2i2012Y�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 endorsemeht(s).. - - � � �� � -• PRODUCER - -'.. .. _ Taggart & Associates, Inc. ,' 1600. Canyon Boulevard P. O.BOX '147 Boulder CO 80306 CONTACT Courtney Ouellette, PWCAM NAME: Y PHONE . (303) 442-1484 FAX ` . (303)4e2-ee22. EMAIL Ess.courtneyo@taggartinsurance.com - -- INSURERS AFFORDING COVERAGE NAICN INSURER A:Cinci=ati Insurance Companies 10677 INSURED U Wyatt Construction CO. Inc. 3223 Arapahoe Ave. Suite 100 Boulder CO 80303 INSURER B: INSURER C: INSURER D: INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: 12-13 Master 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 SUBR POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS A _:. GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EPP0138088 /1/2012 - /1/2013 _ EACH OCCURRENCE $ 1,000,000 DAMAGE TO PERTMT— PREMI E Ea occurrencel $ 500,000 MED FXP(Any one person) $ 10,000 PERSONAL B ADV INJURY $ 1,000,000 `•'i°"' GENERAL AGGREGATE $-'2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X1 POLICY PRO_, .� LOC IFCT PRODUCTS - COMPIOP AGG. $...2',000 /000 A AUTOMOBILE X LIABILITY • ANY AUTO"-- ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PP0138088 5/1/2012 /1/2013 COMBINED SINGLE LIMIT' - Eaaccidienl - - _ 1 000 000 BODILY INJURY (Per person) $- BODILY INJURY (Pereceitlent) $ PROPERTY DAMAGE Per accclent $ Medical payments $ 5,00 A X UMBRELLA LIAR EXCESS LIAR X OCCUR CLAIMS -MADE 0P0138088 /1/2012 /1/2013 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, desuibe under DESCRIPTION OF OPERATIONS below N/A WC $TATU- OTH- 11 - E.L. EACH ACCIDENT $ E L DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, K more space is required) LM a Lt$1 a 1"111 wSl PJ R U 4Le City of Fort Collins PO Box 580 Fort Collins, CO 80522 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 C Ouellette, PWCAM/AB cq_4k '`_J- oU_k�Q I ACORD 25 (2010/05) ©1988-2010 ACORD INS025 (201005).01 The ACORD name and logo are registered marks of ACORD Additional Named Insureds Other Named Insureds GC Condos 2006, LLC Additional Named Insured Wyatt Lofts II LLC Additional Named Insured Wyatt Lofts LLC Additional Named Insured Wyatt Mid Town LLC Additional Named Insured OFAPPINF (02/2007) COPYRIGHT 2007, AMS SERVICES INC