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HomeMy WebLinkAbout365691 BRYAN CONSTRUCTION INC - INSURANCE CERTIFICATE (6)30055 ACb o® CERTIFICATE OF LIABILITY INSURANCE DAT4/29/013/2013 Y) /29 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(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 endomement(s). PRODUCER Commercial Lines - (719) 592-1177 CONTACT Amber C. Keller NAME: PHONE 800-332-9256 FAX 877-405-9032 .(A1C,.Np,_EXD' NC Noj: E-MAIL ADDRESS: Wells Fargo Insurance Services USA, Inc. INSURERS) AFFORDING COVERAGE NAIC Y 5755 Mark Dabling Blvd., Suite 300 Colorado Springs, CO 80919-2228 INSURER A : Valley Forge Insurance Company 20508 INSURED �n0� INSURER B: Continentals Casualty Company 20443 Bryan Construction, Inc. �J " Ir INSURERC: Pinnacol Assurance Company 41190 7025 Campus Drive INSURER D: INSURER E INSURER F : Colorado Springs, CO 80920-3164 COVERAGES CERTIFICATE NUMBER: 5970123 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 ADDL SUBR POLICY EFF POLICY EXP LTR M POLICY NUMBER M/DDYYYY MM/DD/YYYY) LIMITS A GENERALLIABILfrY X COMMERCIAL GENERAL LIABILITY 4029167470 4/30/2013 4/30/2014 EACH OCCURRENCE $ 1.000,000 REDAMMI ESESSO omRENTED P PREMIEa unence $ 300,000 CLAIMS -MADE a OCCUR MED EXP(My one person) $ 15.000 PERSONAL B ADV INJURY $ 1,000,000 GENERALAGGREGATE $ 2.000,0D0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ 2.000,000 RO LOC POLICY X PLCT $ B AUTOMOBILE LIABILITY 4029167484 4/30/2013 4/30/2014 COMBINED SINGLE LIMIT Ea accident 1,000,000 XNON-OWNED BODILY INJURY (Per person) $ AUTO ALL OWNED SCHEDULED AUTOS AUTOS IANY (Per ) BODILY INJURYideni accident) $ X PROPERTYDAMAGE Per accident $ HIRED AUTOS X AUTOS X $ PP Autos UMBRELLA UAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ C WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/ XECUTIVE OFFICERIMEMBER EXCLUDED? NIA 2310880 2/1/2013 2/1/2014 X WC STATU- OTH- TOBYLIMOs. _ E.L. EACH ACCIDENT g 1,000,000 E.L. DISEASE - EA EMPLOYEd $ 1,000,000 (Mandatory In NH) If yes. dosmbe under DE SCRIPTIONOFOPERATIONSbelow E. L. DISEASE - POLICY LIMIT $ 1.000.000 DESCRIPTION OF OPERATIONS / LOCATIONS VEHICLES (ANach ACORD 101, Additional Remarks Schedule, if more space Is required) The certificate holder is listed as additional insured in regards to the 7136 Lincoln Center Addition and Renovations project. City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 300 Laporte Avenue THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE _.-.- The ACORD name and logo are registered marks of ACORD © 1988.2010 ACORD CORPORATION. All rights reserved ACORD 25 (2010105) II II II I I I II I II I I I II I I I II II III I I I II II I I II