HomeMy WebLinkAbout166269 GARNEY CO INC - INSURANCE CERTIFICATE (3)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
Garrey Companies Inc 1 hb"j/� f NAME AND Liberty,
1333 NW Vivion Road ADDRESS
OF INSURED Mutual®
Kansas City MO 64118
is, at the issue date of this 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 any requirement, 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
COMPENSATION
10/1 /2013
WA2-640-426942-732
COVERAGE AFFORDED UNDER WC
LAW OF THE FOLLOWING STATES:
AL, AR, AZ, CO, FL, GA, IA, KS,
KY, MO, NC, NE, NM, OK, SC,
TN, TX, VA-
EMPLOYERS LIABILITY
Bodily Inury by Accident
1 OOO 000EaehA«i&M
Bodily Injury By Disease
1 000 000
Bodily Injury By Disease
1 000 000
COMMERCIAL
GENERAL LIABILITY
10/1/2013
TB2-641-426942-722
General Aggregate
$2,000,000
Products / Completed Operations Aggregate
❑ OCCURRENCE
2 000 000
❑ CLAIMS MADE
Each Occurrence
$1,000,000
Personal & Advertising Injury
1 OOO OOO Per Person /Organization
RETRO DATE
DTY00,000 Fire Legal tVT0,000 Medical
AUTOMOBILE
LIABILITY
10/1/2013
AS2-641-426942-712
Each Accident —Single Limit
$2,000,000 B.I. And P.D. Combined
OWNED
Each Person
Each Accident or Occurrence
mNON -OWNED
0 HIRED
Each Accident or Occurrence
OTHER
ADDITIONAL COMMENTS
Re: Job #6652 Canal Importation Ponds and Outfall WO # 18 ‐ 2013 Glenmoor
Maintenance
City of Fort Collins is additional insured as their interest may appear where required by written contract on Auto Liability
and General Liability.
If the certificate expiration date is continuous or extended term, you will be notified if coverage 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 CALJCEL OR REDUCE THE
INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST 6U DAYS NOTICE
OF SUCH CANCELLATION HAS BEEN MAILED TO:
J b #6652 C I I : P d
Liberty Mutual
Insurance Group
o ana mportatlon on s
Fty of Fort Collins
Laura Rudolph
St. Louis /0442
AUTHORIZED REPRESENTATIVE
12250 Weber Hill Road
300 LaPorte Avenue
St. Louis
MO 63127 800-392-9223 10/26/2012
Lort Collins CO 80521
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