HomeMy WebLinkAbout166269 GARNEY HOLDING CO - INSURANCE CERTIFICATE (8)Certificate of Insurance
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFICATE HOLDER. THIS CERTIFICATE IS NOT AN
INSURANCE POLICY AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. POLICY LIMITS ARE NO LESS THAN THOSE
LISTED, ALTHOUGH POLICIES MAY INCLUDE ADDITIONAL SUBLIMIT/LIMITS NOT LISTED BELOW.
is to Certify that
This
' Garney Holding Comppany/Garvey Companies Inc./
Grimm Construction Co. Inc./Garney Federal, Inc./
Encore Construction Group, Inc.
NAME AND
ADDRESS
1333 NW Vivion Road
Kansas City MO 64118-4554
OF INSURED
pi �
117- INSURANCE
is, at the issue date of this certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ies) is subject to all their terms, exclusions and
Conditions and is not altered by any requirement, term or condition of any contract or other document with respect to which this certificate may be issued.
EXP DATE
El CONTINUOUS
TYPE OF POLICY
❑ EXTENDED
POLICY NUMBER
LIMIT OF LIABILITY
Z POLICY TERM
WORKERS
10/1/2019
WA2-64D-426942-738
COVERAGE AFFORDED UNDER WC
LAW OF THE FOLLOWING STATES:
EMPLOYERS LIABILITY
COMPENSATION
Includes Coverage 3C, Other
all other states
AL, AR, AZ CA, CO, FL GA, HI,
IA IN KS ICY LA, MD MOMS,
Bodily Injury by Accident
1 OOO 000 Each Accident
States Insurance: All States
NC`, KE, Nm, OK, SC, tN, Y) , UT
Bodily Injury By Disease
except those listed and the
WC2-641-437723-908
VA, VT, WV
states of ND, OH, WA, and
(Wisconsin)
WC2-641-437723-908 policy - WI
1 000 000
Bodily Injury By Disease
1 000 000 Each Person
COMMERCIAL
10/1/2019
TB2-641-426942-728
General Aggregate
GENERAL LIABILITY
$4,000,000
OCCURRENCE
Products / Completed Operations Aggregate
$4,000,000
❑ CLAIMS MADE
Each Occurrence
$2 000 000
Personal & Adacttising Injury
R1:IRO DA'IN
$2,000,000 Per Person /Organization
Other
)thcr
$300,000 Damage to Premises
$10,000 Medical Expense
Rented to You
AUTOMOBILE
10/1/2019
AS2-641-426942-718
Each Accident —Single Limit
$2,000,000 B.I. And P.D. Combined
LIABILITY
Each Person
OWNED
Each Accident or Occurrence
0 NON -OWNED
HIRED
Each Accident or Occurrence
OTHER
ADDITIONAL COMMENTS
Garvey Job # Work Order
Job Name: 1416 Castlerock Sewer Service Repair
City of Fort Collins is additional insured with regards to general liability and automobile liability, as their interest may appear, where required by
written contract.
• If the certificate expiration date is continuous or extended term, you will be notified if coverage is terminated or reduced before the certificate expiration date.
NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.)
BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT CANCEL OR REDUCE THE
INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST 60 DAYS NOTICE
OF SUCH CANCELLATION HAS BEEN MAILED TO:
1416 Castlerock Sewer Service Repair
City of Fort Collins
PO Box 580, 700 Wood Street
e3 Fort Collins CO 80522-0580
i° x
U
Overland Park / 033S
8700 Indian Creek Parkway, Suite 350
I Overland Park KS 66210 913-681-1700 9/26/2018
LJ OFFICE PHONE
This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those Companies
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LDI COI 268896 02 11
Liberty Mutual
Insurance Group
Stacy Spieker
AUTHORIZED REPRESENTATIVE
DATE ISSUED
NM 772 07-10