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HomeMy WebLinkAbout365691 BRYAN CONSTRUCTION INC - INSURANCE CERTIFICATE (7)3W55 �® CERTIFICATE OF LIABILITY INSURANCE DAT5/612ONYYV) 5/6/2013 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 Commercial Lines - (719) 592-1177 CONTACT Amber C. Keller NAME: PHONE FAX _(AC, No, 800-332-9256 A/c Nn1_877-405-9032 EWAIL ADDRESS: Wells Fargo Insurance Services USA, Inc. _ INSURERS) AFFORDING COVERAGE NAIC p 5755 Marl( Cabling Blvd., Suite 300 Colorado Springs, CO 80919-2228 INSURERA: Valley Forge Insurance Company _ 20508 _ INSURED LL Bryan Construction, Inc. 3 p� INSURER B: Continental Casually Company 20443 INSURER C: Pinnacol Assurance Company 41190 7025 Campus Drive INSURER D INSURERE: INSURER F Colorado Springs, CO 80920-3164 COVERAGES CERTIFICATE NUMBER: 6017438 REVISION NUMBER: See helnw 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 l'ERIAS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SURR l� POLICY EFF POLICY E%P LTR TYPE OF INSURANCE POLICY NUMBER IMMIDDrYYYYI (MMIDONYTnI LIMITS A GE N ERALUABIUTY X COMMERCIAL GENERAL LIABILITY 4029167470 4/30/2013 4I30/2014 EACH OCCURRENCE DAMAGETO RENTED PREMISES_(Ea occurrence __ $ 1000000 -- $ 30,0000 MED EXP(Any one person) _ $ 15,000 CLAIMS -MADE OoccuR PERSONAL 8 ADV INJURY _ $ 1,000,000 _ AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: _GENERAL PRODUCTS - COMP/OP AGG 2.00).000 POLICY X PRO 7 LOC _$ $ B AUTOMOBILE LIABILITY 4029167484 4/30/2013 4/30/2014 COMBINED SINGLE LIMITii 1000.000 -Laaccident) BODILY INJURY(Per person) $ ANY AUTO ALL OWNED AUTOS AUTOS SCHEDULED I BODILY INJURY Per accitlent () $ —XI PROPERTY DAMAGE ec idenl)_PP $ XNON-OWNED HIRED AUTOS AUTOS -(Par $ Autos UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE _ $ EXCESS LIAR CLAIMB-MADE DED RETENTION$ _ § C WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETORIPARTNERIEXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? NIA 2310880 2/1/2013 2/1/2014 % WC BTAm- OTH —_TQRY11huTS _ _ER_______ . EL. EACH ACCIDENT - _ $ 1.000000 E.L. DISEASE -EA EMPLOYEE $ 1000,000 (Mandatory in NH) If yes, desc flue under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it 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 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 ooa» The ACORD name and logo are registered marks or ACORD © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 11111111111111111111111111111111111111111111111111111111111111111111111111111111 •craolAOMwousmzezromrom•