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Home My WebLink About481078 BRINKMAN CONSTRUCTION INC - INSURANCE CERTIFICATE (2)ACORD,. CERTIFICATE OF LIABILITY INSURANCE 2/17/2019 F DATE(MM/DD/YYYY) 1 2/14/2018 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 Lockton Companies TA NAME: 8110 E. Union Avenue Suite 700 Denver CO 80237 PHONE A A/C No Ext : A C No): E-MAIL ADDRESS: INSURER AFFORDING COVERAGE NAIC # (303) 414-6000 INSURER A: Liberty Mutual Fire Insurance Company 23035 INSURED Brinkman Construction, Inc. 1392944 3528 Precision Drive Suite 100 Fort Collins, CO 80528 INSURER B : First Mercury Insurance Company 10657 INSURER C : Pinnacol Assurance Company 41190 INSURER D : Indian Harbor Insurance Company 369¢0 INSURER E : IN URER F : COVERAGES CERTIFICATE NUMBER: 13934794 REVISION NUMBER: XXXXXXX 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 LTR TYPE OF INSURANCE ADDL IN D SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y T62Z91468478028 2/17/2018 2/17/2019 EACH OCCURRENCE _ 1 ,000,000 CLAIMS -MADE OCCUR DAMAGE (ETO a occurrence 100.000 MED EXP (Any oneperson) 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. POLICYa PRO- LOC P1 GENERAL AGGREGATE $ 2 000MO PRODUCTS - COMP/OP AGG $ 2,000.000 $ OTHER A AUTOMOBILE LIABILITY Y N AS2Z91468478018 2/17/2018 2/17/2019 COMBINED SINGLE LIMIT Ea accident $ 11000,000 X BODILY INJURY (Per person) $ XXXXXXX ANY AUTO OWNEDAUTOS ONLY AUTOSSCHED BODILY BODILY INJURY (Per accident $ XXXXXXX PROPERTY DAMAGE Per accident $ XXXXXXX HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ XXXXXXX E3 UMBRELLALAB NOCCUR Y N CAEX0000061794 2/17/2018 2/17/2019 EACH OCCURRENCE $ 10,000,000 X AGGREGATE $ 10,000,000 EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ XXXXXXX C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE � OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A Y 4197967 1/1/2019 1/1/2020 X STATUTE O R E.L. EACH ACCIDENT $ 1,000.000 E.L. DISEASE - EA EMPLOYEE 1,000,000 It yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT !1 1,000.000 D Professional/Pollution N N CE07446736 3/13/2018 2/17/2019 Per Claim: $4,000,000 Aggregate: $6,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: 1505 - Poudre Fire Authority Station 48. City of Fort Collins and Poudre Fire Authority are included as Additional Insureds as respects General Liability for ongoing and completed operations, Auto Liability, and Umbrella Liability if required by written contract. Waiver of Subrogation applies in favor of the Certificate Holder if required by written contract. GtK I WIUA I t HULUtK L.AIVI tLLA I IUNI JCC 1ALIUC111nCULS 13934794 City of Fort Collins and Poudre Fire Authority Attn: Gary Nuckols (PFA) Brain Hergott (City) PO 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 ACORN 25 r2n1R/nm n19RR-21115 ACORO CORPORATION- All rights reserved The ACORD name and logo are registered marks of ACORD