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HomeMy WebLinkAbout365691 BRYAN CONSTRUCTION INC - INSURANCE CERTIFICATE (10)30055 ® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 4/29/2015 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 Commercial Lines - (800)-332-9256 Wells Fargo Insurance Services USA. Inc. `'"" NAME:r"'' Amber C. Keller PM°Nu .. ,. 800-332-9256 1 WAX sim. 877-405-9032 90 S. Cascade Ave, 2nd Floor INSURERS) AFFORDING COVERAGE NAIC_ p Colorado Springs, CO 80903 _ INSURER A: Valley Forge Insurance Company 20508 INSURED INSURER a: Transportation Insurance Company 20494 Bryan Construction, Inc. INSURER c: Pinnacol Assurance Company 41190 7025 Campus Drive INSURER D: INSURER E : Colorado Springs, CO 80920-3164 INSURERF: COVERAGES CERTIFICATE NUMBER: 9060001 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 TYPE OF INSURANCE I DLL VD POLICY NUMBER MMIDDA% MMI POLICYEXP LIMITS LTR X COMMERCIAL GENERAL LIABILITY A _ CLAIMS -MADE Al OCCUR 4029167470 4/30/2015 4/30/2016 EACH OCCURRENCE $ PREMISES Ea occurrence $ 300.000 MED EXP (Any one person) $ 15,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: POLICY gCT � LOC PRO DUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: B AIIrOMOBILE LIABILITY 4029167484 4/30/2015 4130=16 P BINED INGLE LIMIT$ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per eaWent) $ PROPERTY DAMAGE Per== ant = NON -OWNED X HIRED AUTOS X AUTOS $ X PP Autos UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LMB CLAIMS -MADE DIED I I RETENTION$ $ WORKERS COMPENSATION C AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE 2310880 (CO) 2/1/2015 2/1/2016 X R OTH- STAT TE ER E.L. EACH ACCIDENT $ 1'�'� OFFICER/MEMBER EXCLUDED? ❑ (Mandatory In NH) N/A E.L. DISEASE - EA EMPLOYE 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1 000 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule. may be attached 11 mom space 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 logo are registered marks of ACORD © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) 111111111111111111 III 11111111111111111 III 111 II 1 'CY80 tA2&001641IOZ01/0/0/0/0'