HomeMy WebLinkAbout166269 GARNEY HOLDING CO - INSURANCE CERTIFICATE (9)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.
This is to Certify that
I Garvey Holding Comppany/Garney Companies Inc./
Grimm Construction Co. Inc./Garney Federal, Inc./ NAME AND
Encore Construction Group, Inc. ADDRESS Li.bertMutual.
1333 NW Vivion Road ���///
Kansas City MO 64118-4554 OF INSURED
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.
TYPE OF POLICY
EXP DATE
❑ CONTINUOUS
❑ EXTENDED
POLICY NUMBER
LIMIT OF LIABILITY
0 POLICY TERM
WORKERS
COMPENSATION
Includes Coverage 3C, Other
States Insurance: All States
except those listed and the
states of ND, OH, WA, and
10/1/2019
WA2-64D-426942-738
all other states
WC2-641-437723-908
(Wisconsin)
COVERAGE AFFORDED UNDER WC
LAW OF THE FOLLOWING STATES:
AL, AR, AZ CA, CO, FL GAHI,
IA IN KS iCY LA, MD M0,MS
Nt, KE, f�M, 6K, SC, tN, Yk, UT
VA, VT, WV
WC2-641-437723-908 policy - WI
EMPLOYERS LIABILITY
Bodily Injury by Accident
1 OOO OOO Each Accident
Bodily Injury By Disease
$1,000,000
Bodily Injury By Disease
1 000 000 Each Person
COMMERCIAL
GENERAL LIABILITY
10/1/2019
TB2-641-426942-728
General Aggregate
$4,000,000
OCCURRENCE
Products / Completed Operations Aggregate
❑ CLAIMS MADE
$4,000,000
Each Occurrence
$2 000 000
Personal & Advertising Injury
$2,000,000 Per Person /Organization
RETRO DATE
Other 10ther
$$300,000 Damage to Premises
Rented to You
$10,000 Medical Expense
AUTOMOBILE
LIABILITY
10/1/2019
AS2-641-426942-718
Each Accident —Single Limit
$2 000,000 B.I. And P.D. Combined
Each Person
2 OWNED
Each Accident or Occurrence
QNON -OWNED
0 HIRED
Each Accident or Occurrence
OTHER
ADDITIONAL COMMENTS
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:
Job: Clearview Sanitary Sewer Repair
[City of Fort Collins - Utilities
700 Wood Street
Fort Collins CO 80522
u
Liberty Mutual
Insurance Group
3� I "" �.
Stacy Spieker
Overland Park / 033S AUTHORIZED REPRESENTATIVE
8700 Indian Creek Parkway, Suite 350
Overland Park KS 66210 913-681-1700 9/26/2018
OFFICE PHONE DATE ISSUED
This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is atiorded by those Companies NM 772 07-10
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