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HomeMy WebLinkAbout365691 BRYAN CONSTRUCTION INC - INSURANCE CERTIFICATE (5)W055 �`� �I CERTIFICATE OF LIABILITY INSURANCE DAT1/29/DD/Yrrr) 1 /29/2013 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 pollcy(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 an this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Commercial Lines - (719) 592-1177 CONTACT Amber C. Keller NAME: PHONE 800-332-9256 F'ix 877-405-9032 -fAJr_Na3U: AIC. Nol: EMAIL ADDRESS: Wells Fargo Insurance Services USA, Inc. INSURER(S) AFFORDING COVERAGE NAIC 0 5755 Mark Dabling Blvd., Suite 300 MSURERA: Valley Forge Insurance Company 20508 Colorado Springs, CO 80919-2228 INSURED L I{` A 1INSURER INSURER B : Continental Casualty Company 20443 Bryan Construction, Inc. C S " I C: Pinnacol Assurance Company 41190 7025 Campus Drive INSURER D : INSURER E : 1 INSURER F: Colorado Springs, CO 80920-3164 COVERAGES CERTIFICATE NUMBER: 5533317 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 I ADMITYPE OF INSURANCE INSR, UO POLJCYNUMBER MNIDO/YYYY MMIDUPOLICYEFF Y EXP LTR LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY 4029167470 4/30/2012 4/30/2013 EACHOCCURRENCE - OHMAGE RENTED PREMISES (Ea occvnenm $ 1,000,000 $ 300,000 CLAIMS -MADE I —XI OCCUR MED EXP (Any one person) $ 15,000 PERSONAL A ADV INJURY $ 1,000.000 - GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2.000, 000 POLICY X PRO- LOC $ B AUTOMOBILE LIABILITY 4029167484 4/30/2012 4/30/2013 COMBINED SINGLE LIMIT ea acddent $ 1,000,000 BODILY INJURY (Per person) S % ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per amident) $ % PROPERTYDAMAGE mi Paredenl $ HIRED % NON -OWNED OS AUTOS % 8 Owned PP Au Owned P UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I I RETENTION$ $ G WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE 2310880 2/1/2013 2/1/2014 X WC STATU- OTH- 1 E.L. EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? ❑ NIA E.L. DISEASE EAEMPLOYEE $ 1,000000 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS betas E.L. DISEASE - POLICY LIMIT 8 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AKach ACORD 101, Additional Remarks Schedule, Ir more space a 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 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 The ACORD name and logo are registered marks of ACORD © 1988.2010 ACORD 25 (2010/05) 1111111111111111111111111111111111111 I I 11111 I 1111111111111111111 IIHI 11111111111 reserved.