HomeMy WebLinkAbout250056 WYATT CONSTRUCTION CO INC - INSURANCE CERTIFICATE (3)ACOROP CERTIFICATE OF LIABILITY INSURANCE
DATE (MMDDM VY)
��-
4/27/2015
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
CONTACT Care Butenct
NAME: Y
Taggart and Associates, Inc
PHONE ExtJ; _(303)442-1484 � � No: (303)442-$$22
1600 Canyon Boulevard
E-MAIEADDRss:ebueno@taggartinanrance.com
P. O. Box 147
_ _ INSURER.S)AFFCRDINGCOVERAGE NAICB
Boulder CO 80306
INSURERA:The Cincinnati Insurance Company 10677
INSURED
INSURERB:StPaul Fire 6 Marine
Wyatt Construction Co. Inc.
INSURER C: _
3223 Arapahoe Ave. Suite 100
INSURER D:. _.
INSURER E :
Boulder CO 80303
INSURER F:
COVERAGES CERTIFICATE NUMBER:15/16 Master 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 TYPE OF INSURANCE iNSD W D POLICY NUMBER
LTR
MM DD'YYYY D/Y MMPOLICY EFF LY EXP
D YYY LIMITS
X COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE $
1,000,000
DAMAGETORENTED
500, 000
A CLAIMS -MADE X OCCUR
-PREMISES (Ea occurrence) $_
EPP0138088
5/1/2015
5/1/2016
MED EXP(Any one person) $
10,000
PERSONAL B ADV INJURY $
1,000,000
DENL AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE $
2,000,000
POLICY X PRO-- LOC
JECT
PRODUCTS-COMP/OP AGG $
2,000,000
OTHER
Employee Benefits Each $
1,000,000
AUTOMOBILE LIABILITY
COMBINED IN L LI g
(Ea accident) _ _ _
1,000,000
__ ____
X ANY AUTO
BODILY INJURY Per person) $
A ALL OWNED SCHEDULED EPP0138088
AUTOS
BODILY INJURYx_ ---
5/1/2015 5/1/2016 (Per accident) $
NON -OWNED
PROPERTY DAMAGE $
HIRED AUTOS AUTOS
(Per accident)
$
X UMBRELLA LIAR X OCCUR
EACH OCCURRENCE $
5,000,000
A EXCESS LIAB _ CLAIMS -MADE
AGGREGATE $ _
5,000,000
DIEDT RETENTION$ EPP0138088
5/1/2015 5/1/2016
$
WORKERS COMPENSATION
R I TH-
AND EMPLOYERS' LIABILITY YIN N
__ _ STATUTE_,_-LER
ANY PROPRIETOR/PARTNER/EXECU FIVE
EL EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? N/A
-"
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE. $
_
H yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT I $
B Excess Liability ZUP14N2827415NF
5/1/2015 5/1/2016 Each Occurrence
$5,000,000
Aggregate
$ 5, 0 00 , 0 0 0
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
l.trt I Ir 11.A I C rt VLUCK I IVn
City of Fort Collins
PO Box 580
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
Carey Bueno/CMB O
1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
INS025 (2C1401)