HomeMy WebLinkAboutHALCYON CONSTRUCTION INC - INSURANCE CERTIFICATE (2)A�� ® DATE (MMIDDIYYYY)
CERTIFICATE OF LIABILITY INSURANCE 11/30/20018
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 endorsements .
PRODUCER 1-303-534-4567 CONTACT
NAME:
IMA, Inc. - Colorado Division PHONE FAX
No-Ext1:
E-MAIL
denaccounttecho@imaco
1705 17th Street ADDREME SS: rp.00m _
Suite 100 INSURER(S) AFFORDING COVERAGE NAIC9 _
Denver, CO 80202 INSURERA:TRAMSPORTATION INS CO (CNA) 20494
INSURED INSURERS: CONTINENTAL CRB CO (CHR) 20443
Halcyon Construction, Inc. _INSURER CCONTINENTAL INS CO (CNA) 35289
4627 N. 20th St., Suite B INSURERD:PINNACOL ASSUR 41190
INSURER E :
Greeley, CO 80634 INSURER F:
COVERAGES CFRTIFICATF Nt1MRER- 54671422 RFVISInN Nt1MRFR-
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 W;TH 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
SUBR
POLICY NUMBER
POLICY EFF
M
POLICY EXP
- -
LIMITS
A
X
COMMERCIAL GENERAL LIABILRY
6075663239
12/05/18
12/05/19
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE a
PREMOCCUR DAMAGE T RENTED
PREMISES Ea ooclnence
$ 100, 000
X
MED EXP (Arty one person)
$ 15,000
BI/PD Ded: $10, 000
PERSONAL 4 ADV INJURY
$ 1,000,000
AGGREGATE LIMIT APPLIES PER
GENERAL AGGREGATE
$ 2,000,000
GENL
POLICY jE`CT LOC
PRODUCTS -COMP/OPAGG
$ 2,000,000
$
OTHER,
B
AUTOMOBILE LIABILITY
6075662737
12/05/19
12/05/19
COMBINED SINGLE LIMIT Ea accident
$ 1,000,000
BODILY INJURY (Per person)
f
Z ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per sccklent)
f
PROPERTY DAMAGE
Per accident
_
= HIRED E NON -OWNED
AUTOS ONLY AUTOS ONLY
_
s
C
X
UMBRELLA I"
M
OCCUR
6075755001
12/05/18
12/05/19
EACH OCCURRENCE
f 5,000,000
AGGREGATE
$ 5,000,000
EXCESS I"
CLAIMS -MADE
DED E RETENTION: 10, 000
f
D
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY YIN
ANYPROPRIETORIPARTNEWEXECUTIVE
OFFICERIME MBER EXCLUDED?
(Mandatory In NH)
NIA
4160879
Ol/Ol/19
Ol/Ol/20
X STATUTE ERR
El EACH ACCIDENT
$ 1,000,000
E.L. DISEASE -FA EMPLOYEE
$ 1,000,000
II descnbe under
DESCRIPTION OF OPERATIONS bel w
El. DISEASE - POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, AddlSonal Remarks Schedule, may he aeached N more spas Is required)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
�ity of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
BOX 580 AUTHORIZED REPRESENTATIVE
t Collins, CO 80521 USA
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2018l03) The ACORD name and logo are registered marks of ACORD
2018spm60
54671422