HomeMy WebLinkAboutBRB CONTRACTORS INC - INSURANCE CERTIFICATE (3),acoRO® CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD YYYY
3/21/2014
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 endorsements .
PRODUCER
Cretcher Heartland
4551 W. 107th St., Third Floor
Overland Park KS 66207
CONTACT
NAME:
PHONE F I No 9111543.4148
E-MAIL
ADDREss:
INSURERS AFFORDING COVERAGE NAIC S
INSURER A.TrBVelerS Property Casualty
25674
INSURED
INSURER Amerisure Insurance Company
19488
INSURER C' 'sure Mutual Ins Co
23326
BRB Contractors, Inc.
INSURER D:
3805 NW 25th Street
Topeka KS 66618
INSURER E:
NSURER F:
COVERAGES CERTIFICATE NUMBER: 340357376 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
L
OF INSURANCE
L
ADDrypE
I
U
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY E%P
M D
DMITS
B
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE ITI OCCUR
Y
Y
GL20753590201
/1/2014
/1/2015
EACH OCCURRENCE
$1,000,000
A e nen
PREMISES
$100000
MED EXP (Any one arson
$10 000
PERSONAL &ADV INJURY
$1000000
GENERAL AGGREGATE
$2 000 000
GEN'L AGGREGATE
17 POLICY
LIMIT APPLIES PER:
X iECPRO- LOC
PRODUCTS - COMP/OP AGG
$2000,000
It
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS TOS
NON —OWNED
HIRED AUTOS AUTOS
0T63076448706TIL12
/1/2014
/1/2015
.accident
1000000
X
BODILY INJURY (Par pawn)
$
BODILY INJURY (Per accident)
It
PROPERTY DAMAGE
IFer accident)
$
A
X
UMBRELLA LIAR
E%CESS LIAR
X
OCCUR
CLAIMS -MADE
ZUP41M0096114NF
11/2014
1112015
EACH OCCURRENCE
$15,000,000
AGGREGATE
$15.000,000
DED X RETENTION $0-
Is
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY
OFFICER/MEN PROPRIETORPARTNEWEXER EXCLUDED? ECUTIVE FN
(Mandatory In NH)
If yea, describe under
DESCRIPTION OF OPERATIONS balm
N / A
WC207534902
11/2014
/112015
X WCSTATJU OTH-
LIM
E.L. EACH ACCIDENT
—
$1 004000
E.L. DISEASE -EA EMPLOYE
$1 000 000
E.L. DISEASE -POLICY LIMIT
1 $i 000 000
A
D
Builders Risk/install Floater
Professional/Pollution
QT6307644B70STIL12
CZB276178830
11/2014
/712014
1112015
0/2015
Limit "SEE BELOW'
Dad 2,500
Poll Lm[Claim/Agg 2,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Romance 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 & Risk Mgt
215 North Mason St., 2nd Floor AUTHORIZED REPRESENTATIVE
Fort Collins CO 80524
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ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORO