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HomeMy WebLinkAbout365691 BRYAN CONSTRUCTION INC - INSURANCE CERTIFICATE (9)30055 ALA �® CERTIFICATE OF LIABILITY INSURANCE D"4128/2014 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 pollcy(les) 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 Wells Fargo Insurance Services USA, Inc. CONTACT Amber C. Keller NAME: PHONE FAX ANC. No, Es) 800-332-9256 (SIC Ne, 877 -405-9032 E-MAIL ADDRESS: INSURERS) AFFORDING COVERAGE NNC 0 5755 Mark Dabling Blvd., Suite 300 Colorado Springs, CO 8099119-12228 INSURER A: Valley Forge Insurance Company 20508 INSURED �15 U INSURER B; Transportation Insurance Company - 20494 Bryan Construction, Inc. _ INSURER C : Plnnacol Assurance Company 41190 7025 Campus Drive INSURER D : INSURER E : INSURER F: Colorado Springs, CO 80920-3164 COVERAGES CERTIFICATE NUMBER: 7644363 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 ADOL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MWDDNYYY MWDDIYYYY LIMITS q X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR 4029167470 4/30/2014 4/30/2015 EACH OCCURRENCE DAMAGERENTED PREMISESS -(Ea occunence)_ $ 1, 000.000 It 300,000 i 15,000 MED EXP (Any one person) PERSONAL S ADV INJURY S 1,0D) coo GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JEC LOC PRODUCTS - COMPIOP AGG $ 2.000,D00 $ OTHER: B AUTOMOBILE LIABILITY 4029167484 4/30/2014 4/30/2015 COMBINED SINGLE LIMIT Ee accident) $ 1,000,000 x BODILY INJURY (Per person) S ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accldeM) S x PROPERTY DAMAGE Per accidenq $ NON -OWNED HIRED AUTOS x AUTOS x 1 PP Autos UMBRELLA LIMB _ OCCUR EACH OCCURRENCE 5 AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEO I I RETENTIONS $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE 2310880 (CO) 2/1/2014 2/1/2015 x PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? ❑ NIA -- — DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory In NH) IE._L. It yes, descrlhs ender DESCRIPTION OF OPERATIONS Laiow E.L. DISEASE -POLICY LIMIT f r,oad,doo DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, my he alhchad It mods span 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 The ACORD name and loco are recistered marks of ACORD © 1989-2014 ACORD CORPORATION_ All rights resarved ACORD 25(201, 01) 11111111111111111111111111111111111IN11111111111111111111111111111111111111111111111111111 'CYBOtAYBl00135BNLe2NIW0A'