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109256 BARKER CONSTRUCTION CO - INSURANCE CERTIFICATE (2)
BARKCON-01 MAR: CERTIFICATE OF LIABILITY INSURANCE DATE (MM/019YY) 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 NAME' CT Shaieen Martin Six & Geving Insurance, Inc. PHONE FAX 225 Union Blvd. #575 (A/C, No, Ext): (720) 962-0930 (A/C. No):(720) 962-0942 Lakewood, CO 80228 ADDRESS,.smartin@six-geving.com INSURED Barker Construction Co Inc. Flip 142 North Timberline Road Fort Collins, CO 80524 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: N JC# 21415 41190 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 TYPE OF INSURANCE 'ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR 5X86476 5/1/2019 5/1/2020 DAMAGE TO RENTED -PREMISES (Ea orLcurrenc 500,000 $ 10,000 MED EXP (Anv one erson PERSONAL& ADV INJURY $ 1,000,000 GENERAL AGGREGATE 2,000,000 GEM. AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG 2,000,000 POLICY � X PEa D LOC OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT a accident 1,000,000 X ANY AUTO '5X86476 5/1/2019 5/1/2020 BODILY INJURY Perperson) $ BODILY INJURY Per accident $ OWNED SCHEDULED AUTOS ONLY AUTOS Pe�accitlentDAMAGE _ AUTOS ONLY AUTOS SW $ _— — - A► X UMBRELLA LIAB X OCCUR EACH OCCURRENCE 1,000,000 EXCESS LIAB CLAIMS -MADE 5X86433 5/1/2019 5/1/2020 AGGREGATE 1,000,000 DED X RETENTION $ p B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE V / N FFICERIME MBER EXCLUDED? N Mandatoryin NH) N / A 4033353 10/1/2018 10/1/2019 X I PER STATUT OTH- ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE 1,000,000 1,000,000 if yes, describe Under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT A iEquipment Floater 5X86476 5/1/2019 5/1/2020 Leased/Rented 300,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) License DM-374. I:PJmaJaCl City of Fort Collins Building Dept. 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 � k ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD