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HomeMy WebLinkAbout365691 BRYAN CONSTRUCTION INC - INSURANCE CERTIFICATE (4)W055 A� �® CERTIFICATE OF LIABILITY INSURANCE DAT4/27/2DIYYYY) 4/27/2012 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 CONTACT Amber C. Keller NAME: Commercial Lines - (719) 592-1177 PHONE 800-332-9256 FAX 877405-9032 C`No. M: (AIC, NoJ: EJAAIL ADDRESS: Wells Fargo Insurance Services USA, Inc. INSURERS) AFFORDING COVERAGE NAIC N 5755 Mark Dabling Blvd., Suite 300 INSURER A: Valley Forge Insurance Company 20508 Colorado Springs, CO 80919-2228 INSURED 1 INSURER B: Continental Casualty Company 20443 �j Bryan Construction, Inc. O INSURER C Pinnacol Assurance INSURER D : 7025 Campus Drive INSURER E : INSURER F Colorado Springs, CO 80920-3164 COVERAGES CERTIFICATE NUMBER: 4260700 REVISION NUMBER: See below 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 TYPE OF INSURANCE ADOSUBR POLICY NUMBER POLICY O/YYYV ri MMI POLICY LTR L/YYLIMITS A GENERAL LIABILITY OMGENERAL LIABILITY 4029167470 4/30/2012 4/30/2013 EACH OCCURRENCE 'DAMAGE TO RENTED PREMISES EamourrR e $ 1.000,000 $ 300,000 MED EXP JAny one person) $ 15,000 4MERCIAL CLAIMS -MADE OoccuR PERSONAL S ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,W0.000 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGO $ 2,000,000 $ POLICY X PRO LOC B AUTOMOBILE LIABILITY 4029167484 4/30/2012 4/30/2013 COMBINED SINGLE LIMIT (Ea accident 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident E PROPER 81DAMAGE $ X HIRED AUTOS X AUTOSWNED $ X Owned PP Au B UMBRELLA LIAR X OCCUR L4018050001 4/30/2012 4/30/2013 EACH OCCURRENCE $ 1.000,000 X AGGREGATE $ 1.000.000 EXCESS LIAR CLAIMS -MADE OED X RETENTIONS 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS'UABIUTY YIN ANY PROPRIETORIPARTNERJEXECUTIVE 2310880 2/1/2012 2/1/2013 X WC STATU- OTH- -TORYLN1LTS E.L. EACH ACCIDENT $ 1.000,000 OFFICERIMEMBER EXCLUDED? ❑ (Mandatory In NH) N / A E.L. DISEASE - EA EMPLOYEE $ 1,000.0130 If yes. deseries under DESCRIPTION OF OPERATIONS O Wb E.L. DISEASE - POLICY LIMIT $ 1.000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Austin ACORD 101, Additional Remarks ScHadNle, If more space la required) The certificate holder is listed as additional insured in regards to the 7136 Lincoln Center Addition and Renovations project. City of Fort Collins 300 Laporte Avenue Fort Collins, CO 80522 Pfa�Pl9grtfugc 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 m,424 The ACORD name and logo are registered marks of ACORD ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) 111111111111111111IIII 11111111111111111111111111111111111 Hill11111111111111111111111] 111111