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HomeMy WebLinkAbout166269 GARNEY HOLDING CO - INSURANCE CERTIFICATECertificate of Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFICATE HOLDER. THIS CERTIFICATE IS NOT AN INSURANCE POLICY AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. POLICY LIMITS ARE NO LESS THAN THOSE LISTED ALTHOUGH POLICIES MAY INCLUDE ADDITIONAL SUBLIMIT/LIMITS NOT LISTED BELOW This is to Certify that I Garney Holding Cornpa%yGarney Companies Inc./ y�}�'Mutual. } �' Grimm Construction Co. Construction Construction NAME AND Libel 1. r Mu ual Management Inc./Encore Construction Group, Inc. ADDRESS J �33 s Yivion Road t 6626/ OF INSURED Kansas City MO 64118-4554 6/y INSURANCE is, at the issue date of this certificate, insured by the Company under the policy(ics) listed below. The insurance afforded by the listed policy(Les) is subject to all their term, exclusions and Conditions and is net altered by env reg uccasot, term ar ecndition crony contract or other document with respect to which this certificate tray be issued. TYPE OF POLICY EXP DATE ❑ CONTINUOUS ❑ EXTENDED POLICY NUMBER LIMIT OF LIABILITY ❑ POLICY TERM WORKERS COMPENSATION Includes Coverage 3C, Other Stales Insurance: All Mates except those listed and the states of ND, OH, WA, and W 10/1/2014 WA2-64D-426942-733 COVERAGE AFFORDED UNDER WC LAW OF THE FOLLOWING STATES: AL AR AZ CO FL GA IA KS, kV SC, MN Mt N I NIE. NM, OK, EMPLOYERS LIABILITY Bodily iri u . by Accident 1 O 0e h as r Bodily Injury By Disease $1,000,000 Bodily Injury By Disease 1 000 000 Fact Perw, COMMERCIAL GENERAL LIABILITY 10/1/2014 TB2-641-426942-723 General Aggregate $2,000,000 m OCCURRENCE Products / Completed Operations Aggregate $2 OOO OOO ❑ CLAIMS MADE Each Occurrence $1 000 000 Personal & Advertising Injury $1,000,000 Per Peraon/Organimtion RETRO DATE Other $300,000 Fire Legal M1er $10,000 Medical AUTOMOBILE LIABILITY 10/1/2014 AS2-641-426942-713 Each AccidemCoSingle Limit $2 OOO OOO B.I. And P.D. Combined EI OWNED Each Person Each Accident or Occurrence NON -OWNED �mI IJ HIRED Each Accident or Occurrence OTHER ADDITIONAL COMMENTS RE: Pro Ref: Gamey Job No. 6612 CIPO WO #16 Red Fox Meadows Balance to Complete. City of Fort Collins, Colorado, Anderson Consulting Engineers and Ayres Associates are an additional insured under the General Liability and Automobile Liability policy if required by written contract with the Named Insured, but only for the coverage and limits provided by the policy and the additional insured endorsement. * If the certificate expiration date is continuous or exmnded term, you will be notified ifcovemge is terminated or reduced before the certificate expiration date. NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.) BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST 60 DAYS NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO: Gamey Job No. 6612 r Cittyy of Fort Collins, Colorado 4316 LaPorte Avenue Fort Collins CO 80525 „x u L Liberty Mutual Insurance Group x�� �. �� Stacy Spieker Overland Park / 0448 AUTHORIZED REPRESENTATIVE 6800 College Blvd, Suite 700 Overland Park KS 66211-1123 913-681-1700 9/122013 JOFFICE PHONE DATE ISSUED This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those Companies NM 772 07-10 CERT NO.: 176D1989 CLIM GODS: L4_3660 Stacy Spiakar 9/12/2013 6,99a8 AN Page 1 of 1 LDI COI 268896 02 11 Certificate of Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFICATE HOLDER. THIS CERTIFICATE IS NOT AN INSURANCE POLICY AND DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. POLICY LIMITS ARE NO LESS THAN THOSE LISTED ALTHOUGH POLICIES MAY INCLUDE ADDITTOiVAL SUBLIMIT/LIMITS NOT LISTED BELOW, This is to Certify that 1 Gamey Holding Companyy/Garney Companies Inc./ Construction Grimm Construction Co. Construction Menaggement Inc./Encore Construction Group, Inc. NAME AND Liberty Mutual ADDRESS m 1333 NW Vivion Road L_ Kansas City MO 64118-4554 L OF INSURED I INSURANCE is, at the issue date of this certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ies) is subject to all their terms, exclusions, and Conditions and is not altered by a w mauimment. tens or condition of my...tract or other document with respect to which this certificate may be issued. TYPE OF POLICY EXP DATE ❑ CONTINUOUS ❑ EXTENDED POLICY NUMBER LIMIT OF LIABILITY m POLICY TERM WORKERS COMPENSATION Includes Coverage 3C, Other States Insurance: All States except those listed and the states of ND, OH, WA, and 10/1/2014 WA2-64D-426942-733 COVERAGE AFFORDED UNDER WC LAW OF THE FOLLOWING STATES: AL AR AZ CO FL GA IA KS, Kl/, Md MB NC NIE, NM, 6K, SC, TN, TX, VA., WV EMPLOYERS LIABILITY Bodily In u . by Accident 1 000 O Z Bodily Injury By Disease 1 000 000 BWily lnjwy By Dise¢se 1 000 COMMERCIAL GENERAL LIABILITY 10l1I2014 T82-641426942-723 General Aggregate $2,000.000 Products / Completed Operations Aggregate $2 000,000 m OCCURRENCE ❑ CLAIMS MADE Each Occurrence 1 000 000 Personal & Advertising Injury $1,000,000 Per Person/Org¢naation REPRO UAT'p; Other IDther $300,000 Fire Legal $10,000 Medical AUTOMOBILE LIABILITY 10/1/2014 AS2-641-426942-713 BAccident—Single Limit $2 000,000 B.1. And P.D. Combined r�I L OWNED Each Persan Each Accident or Occurrence NON -OWNED rm L•J HIRED Each Accident or Occurrence OTHER ADDITIONAL COMMENTS City of Fort Collins, Colorado, Anderson Consulting Engineers, and Ayres Associates are an additional insured under the General Liability and Automobile Liability policy If required by written contract with the Named Insured, but only for the coverage and limits provided by the policy and the additional insured endorsement. General Liability policy includes contractual liability and explosion, collapse and underground coverage. • If the certificate expiration date is continuous or extended term, you will be notified ifwvemge is terminated or reduced before the certificate expiration rate. NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.) BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT CANCEL OR REDUCE THE NSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST 60 DAYS NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO: Liberty Mutual Insurance Group \ �lY/Wl. F_Cit�yy of Fort Collins, Colorado U Stacy spieker 4316 LaPorte Avenue Fort Collins CO 80522 Overland Park 10448 AUTHORIZED REPRESENTATIVE $ 6800 College Blvd, Suite 700 Overland Park KS 66211-1123 913-681-1700 9/12/2013 LI OFFICE PHONE DATE ISSUED This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those Companies NM 772 07-10 CERT NO.: 17607968 OL1,i Coca: LM_g660 Stacy, apietter 9/12/2013 6:49:20 aM Page 1 or 1 LDI COI 268896 02 11 Certificate of Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFICATE HOLDER. THIS CERTIFICATE IS NOT AN INSURANCE POLICY AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. POLICY LIMITS ARE NO LESS THAN THOSE LISTED ALTHOUGH POLICIES MAY INCLUDE ADDITIONAL SUBLIMIT/LIMITS NOT LISTED BELOW. This is to Certify that I Gamey Holding Comppa%YGamey Companies Inc./ �.}�,Mutual. Grimm Construction Co. Conseaver Construction NAME AND Libel 1 V Management Inc./Encore Construction Group, Inc. ADDRESS - JJJ 1333 NW Vivion Road OFINSURED Kansas City MO 64118-4554 INSURANCE is, at the issue date of this certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ics) is subject to all their terms, exclusions and Conditions and Is not altered by env mouircmenf term or condition of anv contract or other document with respect to which this certificate may be issued. TYPE OF POLICY EXP DATE ❑ CONTINUOUS ❑ EXTENDED POLICY NUMBER LIMIT OF LIABILITY ❑ POLICY TERM WORKERS COMPENSATION Includes Coverage 3C, Other States Insurance: All States except those listed and the states of NO, OH, WA, and 10/1/2014 WA2 fr4D 426942-733 COVERAGE AFFORDED UNDER WC LAW OF THE FOLLOWING STATES: AL AR AZ CO FL GA IA KS, Kl/ Md, M$ N6 Nt, NM, 6K, SC, TN, TX, VA, WV EMPLOYERS LIABILITY Bodily Injury by Aedaem 1 000 000 earn nc rasa: Bodily Injury By Disease 1 000 000 Bodily Injury By Disease 1 000 000 COMMERCIAL GENERAL LIABILITY 10/1/2014 T82-641426942-723 General Aggregate $2,000,000 Produces / Completed Operations Aggregate $2 000,000 m OCCURRENCE ❑ CLAIMS MADE Each Occurrence $1 000 000 Personal & Advertising Injury $1,000,000 Per Person/Organvation RETRO DATE Other $300,000 Fire Legal her $10,000 Medical AUTOMOBILE LIABILITY 10/1/2014 AS2-641-426942-713 Each Accident —Single Limit $2 OOO OOO B.I. And P.D. Combined OWNED Each Person Each Accident or Occurrence NON -OWNED rat 0 HIRED Each Accident or Occurrence O I'HER ADDITIONAL COMMENTS RE: Job # 6627 ‐ 2012 Manhole Lining. City of Fort Collins is an additional insured under the General Liability policy if required by a written contract with the Named Insured, but only for the Coverage and limits provided by the policy and the additional insured endorsement. Ifthe certificate expiration date is continuous or extended term, you will be notified if cavcragc is terminated or reduced before the certificate expiration date. NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW. BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT CANCEL OR REDUCE TT1 INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST 60 DAYS NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO: Job # 6627 ‐ 2012 Manhole Lining Liberty Mutual Insurance Group FCity of Fort Collins 4316 La Porte Avenue Stacy spieker Fort Collins, CO 60522 Overland Park / 0448 AUTHORIZED REPRESENTATIVE 6800 College Blvd, Suite 700 Overland Park KS 66211-1123 913-681-1700 9/12/2013 LI OFFICE PHONE DATE ISSUED This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those Companies NM 772 07-10 CBRT MO.: 17607983 cLIRIrr 000a: U42660 Stacy Spiakor 9/13/2013 6:49:28 AM Page 1 of 1 LDI COI 268896 02 11 Certificate of Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFICAE HOLDER. THIS CERTIFICATE IS NOT AN INSURANCE POLICY AND DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. POLICY LIMITS ARE NO LESS THAN THOSE LISTED ALTHOUGH POLICIES MAY INCLUDE ADDITIOF.IAL SUBLIMm umurrS NOT LISTED BELOW. is to Certify that This I Garney Holding Comppanyy/Garney Companies Inc./ Grimm Construction Co. Inc./Weaver Construction Managgement Inc./Encore Construction Group, Inc. AD E AND Liberty Mutual. ESS P 1333 NW Vivion Road Kansas City MO 64118-4554 OFINSURED INSURANCE is, at the the issue date of this certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ies) is subject to all their torms, exclusions and Condition. and is not altered by any requirement, term or condition of any contract or other document with respect to which this eenificate my be issued. TYPE OF POLICY EXP DATE ❑ CONTINUOUS ❑ EXTENDED POLICY NUMBER LIMIT OF LIABILITY ❑ POLICY TERM WORKERS COMPENSATION Includes Coverage 3C, Other States Insurance: AI: States except those listed and the states of NO, OH, WA, and W 10/1/2014 WA2-64D-426942-733 COVERAGE AFFORDED UNDER WC LAW OF THE FOLLOWING STATES: AL AR AZ CO FL GA IA KS, SC; T1N'TX VA NIE' NM, bK, - EMPLOYERS LIABILITY Bodily Injuy by Awident 1 O OO P.ch Accident Bodily Injury By Disease $1,000,000 Bodily Injury By Disease 1 000 000 COMMERCIAL GENERAL LIABILITY 10l1l2014 T82-641-426942-723 General Aggregate, e $2,000,000 m OCCURRENCE Products / Completed Operations Aggregate $2,000,000 ❑ CLAIMS MADE Each Occurrence 1 000 000 Personal & Advertising Injury $1000,000 Per Person/Organ anon RETRO DATE Other lother $300,000 Fire Legal $10,000 Medical AUTOMOBILE LIABILITY 10/1 /2014 AS2-641-426942-713 Each Accident —Single Limit $2,000 000 B.I. And P.D. Combined r�1 LJ OWNED Each Person Each Accident or Occurrence mNON -OWNED HIRED Each Accident m Occurrence OTHER ADDITIONAL COMMENTS RE: Pro act Ref: Garvey Job No. 6622 CIPO WO #17 Glenmoor Pond Balance to Complete. City of Fort Collins -Colorado, Anderson Consulting Engineers, and Ayres Associates are an additional Insured under the General Liability and Automobile Liability policy if required by written contract with the Named Insured, but only for the coverage and limits provided by the policy and the additional insured endorsement. General Liability policy includes contractual liability and explosion, collapse and underground coverage. • If the cenificate expiration date is continuous or extended term, you will be notified if covcmge is terminated or reduced before the certificate, expiration dare. NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.) BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST 60 DAYS NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO: Garvey Job No. 6622 Liberty Mutual Insurance Group FCityy of Fort Collins, Colorado \ U OT lX/[ f�l. 4316 LaPorte Avenue Stacy spieker �:; Fort Collins CO 80525 Overland Park I0448 AUTHORIZED REPRESEMIV ATE €: 6800 College Blvd, Suite 700 Overland Park KS 66211-1123 913-681-1700 9/122013 LI OFFICE PHONE DATE ISSUED This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those Companies NM 772 07-10 CART NO.: 17407990 CLIM CODS: I,01_2660 Stacy 6pleker 9/12/2013 6:69:28 AM Page 1 of 1 LDI COI 268896 02 11 A`OROW CERTIFICATE OF LIABILITY INSURANCE DATEB/a o9/09/2o13 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. N 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 1-816-621-7788 CONTACT Aubrey NAME y Mayor Arthur S. Gallagher Risk Management Services, Inc. PHONE PAz iyc Ertl: (616) 395-8593 (916) 667-5593 23e5 Grand Blvd., Suite 400 ADDRESS, aabrey-l•ayaLYajg.e wag AFFORawa COVERAGE NAICa Kansas City, NO 64108 INSURER A: Bt Pea lire and Marine IOSOr O CO 26767 Tanner Burns, INSURED Na URER B: Carney Holding p / Oaiea, Inc. / gamey Constrcticm Company, Inc. / Grimm Comtructien Company, MUIURERC: INSURER O: Inc. / Weaver Construction Management, Inc. / Encore Construction Group, Inc. - 1333 NN Vivion Road Kansas City, NO 66118 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 35633113 REVISH)N 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 REOUINEMENT, 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. INBR TOTE OF INSURANCE AWLSUBA INSR MID POLICY NUMBER POUCYEFF M LCYEXP DprYYYYI DYOE amen LIABMITY EACHOCCURRENCE S COMMERCIAL GENERAL LIABILITY MAWWAIAOE ❑OCCUR GE Td RENTEB PREMISES EA $ MEDEXP Ore penal) $ PERSONAL S ADV INJURY S GENERAL AGGREGATE B GENLAOGREGATE LIMIT APPLIES PFA: PRODUCTS - COMPIOP AGG S POLICY PIFCTRO- LOG $ AYTOYOBaE LL1wLRY COMBINED SINGLE UNIT let en ANY AUTO _ BODILY INJURY (Par Ponan) 3 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Par acWIW) S PROPERTY DAMAGE S NON-0WNED HIRED AUTOS AUTOS S A I UMaMELLALIAa X OCCUR X X BOP-14870452-13-MF 10/01/1 10/01/14 EACH OCCURRENCE 6 25,000 000 AGGREGATE $ 25,000,000 EXCESS LIAa CIAIMS-MADE UED I X I RETENTION NM B WORKERS COMPENSATION I WC STATLL I 107141 AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNEWEXECUTNE❑ EL EACH ACCIDENT S OFFICERIMEMBER EXULTED? MIA EL DRIEASE-EAEMPLOYE $ n ((Manama, In NH) Ityw deFalOeurder DESCRIPTION OF OPERATIONS OeW ELOLSEA9E-POUCYL ff B DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IAeach ACORO 101, Addlb,el RenarAe SCIednM, I morn apeu M,e Wu ) Following Form Primary/Underlying Policies with Liberty Mutual Fire Insurance Capany: General Liability including Completed Operations Policy PTB2-6e1-426912-723 Ef. E. 10-1-2013/10-1-201a Auto Liability Policy PAS2-661-626942-713 Xff. 10-1-2013/10-1-2016 Employers Liability/Workers- Compensation Policy 6WA2-64D-426962-733 SEE. 10-1-2013/10-1-2016 Pollowing Form Including Blanket Additional Insured, Primary and Non -Contributory and Blanket Waiver of Subrogation as required by written contract. Includes All Work and Operations Performed by insured covered by Primary/Underlying policies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 5316 LaPorte Avenue AUTHORIZED REPRESENTATIVE Fort Collin, CO 80522 Q T, 1 I USA / ACORD 25 (2010105) aumeyer 35633113 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD m ii PTIw1aIN02 AC40R" CERTIFICATE OF LIABILITY INSURANCE DATE0MMIM9/201113 ) 09/9/2, � 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 INSURERjS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: U the Certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. H 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 endorsament(s). PRODUCER 1-816-421-7788 CONTACT Aubrey Meyer NAME. Arthur J. Gallagher Risk Management Services, Inc. ._ - X coo Enr (816) 395-8593 yt Man. (816) 6(7-5593 ADDRESS; aubray neyerfajo.coID 2365 Grand Blvd., Suite 600 WMWERIMAMostowD COVERAGE WDe Xansas City, NO 66108 WWWRA: lit Paul Fire and Marine InsuranM Co 24767 Tanner Burns INSURED M6URER B: Cerny Bolding Company / Garay Companies, lac. / Sammy Construction Company, Inc. / Grfma, Construction Ccopsay, WWMR C: INSURER D: Inc. / Weaver Construction Msnegeaent, Inc. / ancom Construction Group. Inc. - 1333 NY Vivian Road Kansas City, NO 66118 INSURER E: WSURER F : COVERAGES CERTIFICATE NUMBER: 35633063 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. No TYPE OF MW W CE MKISUBS me POLN:Y NUMaER POLICY EFF POLICY EXIf Illie OENEM LIABNIiY EACH OCCURRENCE 3 COMMERCIAL GENERAL LIABILITY CIAIMS1MpE OCCUR DA MGETORENTEDPREMISn 3 MED IMP lAny one Pelson) 3 PERSONAL a AOV IWURY 3 GENERAL AGGREGATE 3 OENi AGGREGATE UM IT APPl1E3 PER: PRODUCTS -COMPIOP A(i0 3 POLICY PR06 LOC 3 AUTOMp LUJ)MTY COMBINED SINGLE LIMIT a aIJ_— BODILYIWURY(Perpeam) 3 ANY AUTO SCHEDULED ALL OWNED AUTOS ICED AUTOS BODILY INJURY(Pw mmcdNll) 3 PROPERTY ONMGE 3 HIRED AUTOS AgT $ A X UNMIRELU LW X OCCUR X X ZUP-14378452-13-NF 10/01/1 10/01/14 EACH OCCURRENCE 325,000,000 AGGREGATE 3 25,000,000 EXCESSLW CLAIMS -MADE DEO I X RETENTION III BMX S WORKERS COMPENSATION WCSTATU-OTiH FIR AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOMPARTNERIEXECUTIVE❑ E.L.EACHACCIDEW $ OFFICEIUMEMBER EXCLUDED? NIA --- EX DISEASE-EAEMPLOYE $ (YMnMMdryInNH) N yB6 oes.heunO DESCRIPTION OF OPERATIONS helms EL DISEASE - POLICY LIMB 3 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (leech ACORD 101, AddHbna RemwOe Schedule, I1 pose epr N fpuM) Following Porn Primary/Underlying Policies with Liberty Mutual Fire Insurance Company: General Liability including Completed Operations Policy 8TB2-661-626962-723 Bff. 10-1-2013/10-1-2016 Auto Liability Policy 8AS2-661-626962-713 Bff. 10-1-2013110-1-2016 MWloyere Liability/Yorkers' compensation Policy BWA2-66D-626962-733 Zff. 10-1-2013/10-1-2016 follmi.ap Porn Including Blanket Additional Insured, Primary and Non -Contributory and Blanket Waiver of Subrogation es rewired by written contract. Includes All Work and Operations Performed by insured covered by Primary/Underlying policies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins, Colorado THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 3316 LaPorte Avenue AUTHORISED REPRESENTATNE Fort Collins, CO 60522 {� � - II''� USA / ACORD 25 (2010105) aumeyer 35633063 911988.2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD