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HomeMy WebLinkAbout168787 GOLDEN TRIANGLE CONSTRUCTION INC - INSURANCE CERTIFICATE (18)Client#: 51920 8GOLDTRI7 ACORD.. CERTIFICATE OF LIABILITY INSURANCE DATE/11'YYI 12126/20fi/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 endomement(s). PRODUCER Willis of Colorado, Inc. 2000 South Colorado Boulevard Tower II, Suite 900 Denver, CO 80222 CONTACT NAME: PNONEo Eat: 303 722-7776 No: 303 722.8862 N E-MAIL ADDRESS: INSUREINSUREIIII AFFORDING COVERAGE NAILS INSURER A: Valley Forge Insurance Company 20508 INSURED 700 Weaver Park Rdd,,Ste E Inc. Golden Triangle Construction, Q tI� tJ�� INSURERS: National Union Fire Insurance O 19445 INSURER C: Plnnacol Assurance 41190 INSURER D : Atlantic Specialty Insurance 27154 Longmont, CO 80501 INSURER E, Continental Casualty Company 20443 INSURER F : COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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. 7R TYPE OF INSURANCE INSR WVO POLICY NUMBER MBR M/DDYEFF II LIMITS A GENERAL UABILMY X COMMERCIAL GENERAL LIABILITY CVUMS-MADE ❑X OCCUR 2022866738 2/31/2013 12131/2014 OCCURRENCE s1 00 0000 pEEAAACCMHAApp PREMIS ocaarence $500000 MED EXP one $5000 PERSONAL S ADV INJURY $1 000,000 GENERALAGGREGATE s2,000 000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY Fjfl MCaT X LOC PRODUCTS-COMP/OP AGG s2,000,000 It E AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AU705 HIRED AUTOS NNOOTNOSWNED 2022866741 1213112013 12131/2014 COMBINED ISINGLE LIMIT 1,000,000 BODILY INJURY(Parporson) $ BODILY INJURY (Par accident) $ PRRIWERT DAMAGE $ E B X UMBRELLA LIAB EXCESS DAB X OCCUR CLAIMS -MADE BED20748684 1213MO13 1213112014 EACH OCCURRENCE $7 000 000 AGGREGATE s7,000,000 DED I X RETENTION110000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If as, describe under DESCRIPTION OF OPERATIONS below NTA 4013024 1/01/2014 01/01/201 X VJCSTATUj OTH- E.L. EACH ACCIDENT E1 OOO OOO E.L. DISEASE - EA EMPLOYEE S1 000 000 E.L. DISEASE- POLICY LIMIT $1 000 000 D Lease/Rent Equip. 7900050570006 1121311112013 12/31/201 Limit $100,000 Deductible $1,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) City of Ft. Collins 215 N. Mason PO Box 580 Fort Collins, CO 80524 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 ACORD 25 (2010/05) 1 of 1 #S1076685/M1076650 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 8TBEC