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HomeMy WebLinkAboutBOSCO CONSTRUCTORS INC - INSURANCE CERTIFICATE (2)BOSCO-1 OP ID: ADR '44CC>MCERTIFICATE OF LIABILITY INSURANCE DATE(MM/DOYYYY) 1v09112 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 endorsements . - PRODUCER Phone: 303-996-7801 CRS/Surescape Ins. Services I 6600 E. Hampden Ave. Fax: Denver, CO 80224 _ - Erik E. Ulibarri CONTACT ' PNONE FAX ac No E>tt:303-996-7800 - - -INC, No: 303-996-7851 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC 0 INSURER A: CNA - - - - INSURED Bosco Constructors, Inc. INSURER B:Pinnacol Assurance 6568 South Racine Cir Centennial, CO 80111 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 ADOL B POLICY NUMBER /YYYYI MM/DDY (MMIDD111YTI LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I OCCUR INS5888584079 12/01/12 12/01/13 EACH OCCURRENCE $ 1,000,00 PREMISES Eaoccuffence $ - 300,00 MED EXP (Any one person) $5,00 PERSONAL S ADV INJURY $ - 1,000,00 GENERAL AGGREGATE -- $-'" 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRO LOG POLICY I -XI PRODUCTS - COMP/OP AGO' $- 2,000,00 - $ A AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS NON -OWNED X HIRED AUTOS X AUTOS BUAS088584082 12/01/12 12/01/13 COMBINED SINGLE LIMIT Ea accident 1,000,00 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ A )( UMBRELLA LIAB EXCESS 11AB X OCCUR CLAIMS -MADE CUP5088584066 12/01/12 12/01/13 EACH OCCURRENCE $ 4,000,00 AGGREGATE $ 4,000,00 LIED X RETENTION$ 10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, desuibe under DESCRIPTION OF OPERATIONS below NIA 22261280 04/01/12 04/01/13 X WCSTATU- TORY LIMITS ER E.L. EACH ACCIDENT S SOO,OO E.L. DISEASE - EA EMPLOYEE $ 500,00 E. L. DISEASE -POLICY LIMIT 1 $ 500,00 A Leased/Rented Eqp. INS5888584079 12/01/11 12/01/12 Limit: 35.0,00 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) RE: Water/Wastewater Treatment andSiteInfrastructure, Design/Construction Contractor #7220. All policy terms, conditions and exclusions apply. City of Fort Collins, Financia Services - Purchasing Division 215 N. Mason St., 2nd Floor, P Ft. 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 v,! qU4-t ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD