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GH PHIPPS WYOMING INC - INSURANCE CERTIFICATE
Client#: 1082464 GERALH ACORD,. CERTIFICATE OF LIABILITY INSURANCE 1 DATE (MM/DD/YYYY) 9/29/2018 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER USI Colorado, LLC Construction � NAMEACT Client Manager a/co No Ft): 800 873-8500 FAX A/c No): 303-831-5295 P.O. Box 7050 E-MAIL ADDRESS: den.contractors@usi.com Englewood, CO 80155 800 873-8500 INSURER(S) AFFORDING COVERAGE NAIC# INSURER Arch Insurance Company : 11150 INSURED GH Phipps Wyoming, Inc. 1482 Commerce Drive, Unit Y Laramie, WY 82073 INSURER B : Travelers Property cos. Co. of America 25674 INSURER C INSURER D — INSURER E --- INSURER F : COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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. LTRR TYPE OF INSURANCE NSRL SUBR WVD POLICY NUMBER MMfDDNYYY MM1DDn� LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FXOCCUR ZAGLB9220102 0/01/2018 10101/2019 EACH OCCURRENCE $1 000000 PREMISES Ea occurrence _ $100,000 MED EXP (Any one person) $1 O 000 PERSONAL SADVINJURY $1,000,000 _ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 5] ECOT _I LOC OTHER: GENERAL AGGREGATE $2,000,000PR PRODUCTS - COMP/OP AGG _ $2,000,000 $ A _ AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X AUTOS ONLY X NON -OWNED AUTOS ONLY _ _ ZACAT9242202 0/01/2018 10/01/201 EOMB�IfJdeD SINGLE LIMIT 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ _. $ PROPERTY DAMAGE Per accident B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE ZUP15R0315318NF 0/01/2018 10/0112019 EACH OCCURRENCE s25,000,000 _ S25,000,000 $ AGGREGATE DIEDX RETENTION $0 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A _ ZAWCI9389302 0/01/201810/01/201 X PER OTH- _ E.L. EACH ACCIDENT $1 000 000 E.L. DISEASE - EA EMPLOYEE $1 000 000 E.L. DISEASE - POLICY LIMIT $1,000 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) RE: Contractor License #B-475. City of Fort Collins P.O. 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 ACORD 25 (2016/03) 1 of 1 #S23986190/M23979406 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BHRZP