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HomeMy WebLinkAboutG.E. JOHNSON CONSTRUCTION COMPANY INC - INSURANCE CERTIFICATE (2)DATE (MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 09/24/2018 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 have ADDITIONAL INSURED provisions or 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 1-303-534-4567 CONTACT NAME: _ _ _ _ IRA, Iric. - Colorado Division PHONE - - FAX LA/C. No. ExO: _._ __ — jAfC NoV. E-MAIL denaccounttechs@imacorp.com 1705 17th Street ADDRESS. _ _ r'D•._ Suite 100 - _ —_ INSURER(S)AFFORDINGCOVERAGE NAIC9 Denver, CO 80202 INSORERA; CHARTER OAK FIRE INS CO(TRAVELMW INS 125615 INSURED INSURERS: TRAVELERS IND CO 25658 G.E. Johnson Construction Company, Inc. INSURER CAMERICAN GUAR i LIAB INS(Zurich Americ 26247 Attn: Accounts Payable'- 25 North Cascade Avenue, Suite 400 INSURERD: PINUICOL ASSUR 41190 INSURERE: ZURICH AMER INS CO (Pinnacol Assurance) 16535 Colorado Springs, CO 80903 INSURER1. INDIAN HARBOR INS CO(XL Insurance) 36940 rYTVFRAr:FS r:FRTIFICATF NIIMRFR- 54069295 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 �ADDL SUER POLICYNUMBER MMIDDY LTR YYYY MMIDDIYYYY LIMITS A X COMMERCIAL GENERALLIAIMUITY DTC00670C701COF18 10/01/18 10/01/19 EACH OCCURRENCE $ 1,000.000 j GLAndS-MADE I X1 OCCUR DAMAGE TO RENTED -- PREMISESL occunence) 9 1. 000. 000 _ S 5,000 X PD Deductible: $5, 000 MED EXP (Any one person) PERSONALBADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY X...J JECT L LOC PRODUCTS-COMPIOPAGG S 2,000,000 —---------- .—__- $ ._....; OTHER. B AU10MOBILE LIABILITY IDT810067OC701IND18 10/01/18 10/01/19 COMBINED SINGLE LIMIT S 2,000,000 _ X ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY _ AUTOS X HIRED X - NON -OWNED . ; AUTOS ONLY AUTOS ONLY BODILY INJURY (Per aadtlenl) PROPERTY DAMAGE Pe accld nt $ S C X UMBRELLA LIAB X OCCUR _._.. ___ AUC931908407 10/01/18 10/01/19 EACHOCCURRENCE $ 5,000,000 AGGREGATE EXCESS UAB--iCLAIMS-MADE $ 5,000,000 S ULU X I RETENTIONS 0WORKER D E AND YERS'LSATIONILIT AND EMPLOYERS' LIABILITYYIN ANYPROPMETORIPARTNERIEXECUTIVE F OFFICERWEMBER EXCLUDED? (Mandatory in NH) MIA 4048587 - CO ONLY WC463293209-KS,MT,NE,OK, I10/01/i8 XO/01/18 10/O1/19 10/01/19 X STATUTE ERH - - E.L. EACH ACCIDENT ---------- $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000.000 E.L. DISEASE - POLICY LIMIT If yen describe under DESCRIPTION OF OPERATIONS below $ 1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: All Operations. CtKIIFICA1t HULUtK L,AN1_tLLA I IUIN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522-0000 USA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 2016spin60 54069295 P52(AKj2WXj2 SUPPLEMENT TO CERTIFICATE OF INSURANCE DATE 09/24/2018 NAME OF INSURED: G.E. Johnson construction Company, Inc. Attn: Accounts Payable Additional Description of Operations/Remarks from Page 1. Additional Information: Contractors Professional & Pollution Liability: Policy #CE0742016504 Insurer F: See Above Effective Dates: 10/01/18-10/01/20 $10,000,000 Each Claim; $50,000 Deductible SUPP (05/04)