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HomeMy WebLinkAbout168787 GOLDEN TRIANGLE CONSTRUCTION INC - INSURANCE CERTIFICATE (19)Client#: 33463 GOLTRIPC ACORD- CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 112/18/2018 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 NAME: CONTACT Nick Brown Holmes Murphy -Colorado PHONE 720-622-9110 FAX A/C No Ext : A/C, No): 7600 East Orchard Rd, Ste 330 South E-MAIL NB//��holh com ADDRESS: rown@mesmurP Y Greenwood Village, CO 80111 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Valley Forge Insurance Company 20508 INSURED INSURER B : Starr Indemnity & Liability Company Golden Triangle Construction, Inc Pinnacol Assurance Company INSURER C : P Y 41190 700 Weaver Park Rd INSURER D : Continental Casualty Company 20443 Longmont, CO 80501 INSURER E : Berkley Assurance Company 39462 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. INSR TYPE OF INSURANCE ADDL SUB POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DDlY MM/DDMYY A X COMMERCIAL GENERAL LIABILITY 6045613035 12/31/2018 12/31/2019 EACHOCCURRENCE $1 000 000 CLAIMS -MADE X OCCUR PREMISES Ea occurrence $500000 X MED EXP (Any one person) $15 000 PD Ded: $5,000 PERSONAL BADVINJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- POLICY [X JECT LOC PRODUCTS -COMP/OP AGG $ 2,000,000 $ OTHER: _ D AUTOMOBILE LIABILITY 6045613018 12/31/2018 12/31/201 COMaBIN idennED tSINGLE LIMIT Eacc $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY PROPERTY DAMAGE Per accident $ B UMBRELLA LIAB X OCCUR 1000584866181 12/31/2018 12/31/2019 EACH OCCURRENCE $10000000 X AGGREGATE $1 O 000 000 EXCESS LIAB CLAIMS -MADE DED I X RETENTION $O $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/ N OFFICER/MEMBER EXCLUDED? F_N1 (Mandatory in NH) NIA 4197806 1/01/2019 01/01/2020 X PERTUTE OTH- E.L. EACH ACCIDENT $1 000,000 E.L. DISEASE - EA EMPLOYEE $1 000 000 E.i_ DISEASE - POLICY LIMIT _1 $1 000 000 i +__._ If Dyes, describe under DESCRiPTIOW OF OPERATIONS below D Lease/Rent Equip 6072739692 12/31/2018 12/31/201 $100,000/$2,500 Ded D Sched Equip Repl Cost/$2,500 Ded E Prof/Pollution PCADB50066971218 12/31/2018 12/31/201 $1 000 000 / $50k Ded DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Contractors License CERTIFICATE City of Fort Collins 215 N. Mason PO Box 580 Fort Collins, CO 80524 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 44 ACORD 25 (2016/03) 1 of 1 1fQAn4Qd9/Mdn'%77Q ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD VA119