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BRB CONTRACTORS INC - INSURANCE CERTIFICATE (2)
ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MMI00 YYY) 3/22/2013 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 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 NAMEACT Theresa Bebout Cretcher Heartland LLC ArcE11_ _ FAX Ne;913 643 4148 4551 West 107th Street, Third Floor E-MAIL Overland Park KS 66204 AODRE55: INSURERS AFFORDING COVERAGE NAIC p INSURER A:LII]ertV InSDrancelJndenci INSURED INSURERB-Travelers Pr perty-Casualty 25674 INSURERC:AmerISU[e_tnsuranCBCOmpan BRB Contractors, Inc. 94s8 NW 25th Street 33W INSURER D: Ameasure MutuaUos—CO Tope Topeka KS 66618 INSURER E:CQ-1(Jm la —Casualty CD. NA INSURER F COVERAGES CERTIFICATE NUMBER: 523418496 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 ADDLSUBR INSR IWO POLICY NUMBER POLICY FEE MMIDOIVVVY POLICY EXP N IDGIYVVV LIMITS C GENERAL LIABILITY Y Y GL20753590101 /1/2013 1/1/2014 EACH OCCURRENCE $1,000000 DAMAGEI RENTED PREMISESSEaoccunence 8100,000 X COMMERCIAL GENERAL LIABILITY CLAIMS-AMDE OCCUR MED EXP(Any one person) $10,000 PERSONAL B ADV INJURY S1,000,000 GENERAL AGGREGATE $2,000.000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $2.000,000 0- n LOC POLICY X "CT C AUTOMOBILE LIABILITY CA20753500201 4/l/2013 /1/2014 L (Ea.deIrani) $1,000000 X BODILY INJURY (Per person) $ ANY AUTO ALL OI� SCHEDULED IHI SCHEDSCHED AUUTOSSAUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accitlent S NON -OWNED HIRED AUTOS AUTOS $ A X UMBRELLA LIAB X OCCUR EXCLA2079853 14/1/2013 4/1/2014 EACH OCCURRENCE $15,000,000 AGGREGATE $15,000,000 EXCESS LIAB CLAIMS -MADE DED IX I RETENTION $ -0- $ D WORKERS COMPENSATION ANDEMPLOYERS'LIABILITV Y/N—I-IQRY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMVEEN EXCI.-DED? Ein N/A WC207534901 /l/2013 /1/2014 X WC STATU- OTH- LIMIT E.L. EACH ACCIDENT $1,000,000 EL DISEASE - EA EMPLOYEE $1,000,000 (Mandatory NH) It DEunder SCR PTION OF OPERATIONS hCION E.L. DISEASE -POLICY LIMIT $1,000,000 B E Builders Risk Installation Floater T6307644B708TIL12 14/1/2013 ZB276171830 d/1/2014 ti/7/2014 Limit "SEE BELOW' Ded 2.500 Professional/Pollution i4R/2013 I Poll Lmt Claim/Agg 2.000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN James O'Neill, CPPO, FNIGP, City Of Fort Collins, ACCORDANCE WITH THE POLICY PROVISIONS. Director Purchasing 8 Risk Mgt 215 North Mason St., 2nd Floor AUTHORIZED REPRESENTATIVE Fort Collins CO 80524 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD