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HomeMy WebLinkAboutGRAYCOR CONSTRUCTION COMPANY INC - INSURANCE CERTIFICATE/ T a ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 5/8/2019 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 ACIG Insurance Agency, Inc. 2600 N. Central ExpwV. Suite 800 NAMEACT PHONE 972-702-9004 aC No: 972-687-0601 E-MAIL ADDRESS: accountmanagers@acig.com Richardson, TX 75080 INSURERS AFFORDING COVERAGE NAIC # INSURER A: American Contractors Ins. Co. RRG 12300 www.acig.com INSURED Graycor Construction Company Inc. Two Mid America Plaza, Suite 400 INSURER B: ACIG Insurance Company 19984 INsuRERc: INSURERD: Oakbrook Terrace IL 60181 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 48580963 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 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 SUBR POLICY NUMBER POLICY EFF MMIDDfYYYY POLICY EXP MM IDD//YYYY LIMITS A �/ COMMERCIAL GENERAL LIABILITY GL19A00016 6/1/2019 6/1/2020 EACH OCCURRENCE $10000000 A A CLAIMS -MADE V OCCUR GL19600016 (GL Excess) GL19C00016 (GL Excess) 6/1/2019 6/1/2019 6/1/2020 6/1/2020 DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5 000 PERSONAL & ADV INJURY $ 10 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 10,000,000 POLICY ✓❑ JE T LOC PRODUCTS - COMP/OP AGG $ 10,000,000 $ OTHER: A AUTOMOBILE LIABILITY AL19000008 6/1/2019 6/1/2020 EaaBcideDtSINGLELIMIT $5,000000 BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY r PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAB DED RETENTION $ $ B B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? ❑N N/A WCA000010019 WCA000005919 WCA000013219 6/1/2019 6/1/2019 6/1/2019 6/1/2020 6/1/2020 6/1/2020 �/ SPER TATUTE EORH E.L. EACH ACCIDENT $ 1 00O 000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1 ,000000 E.L. DISEASE - POLICY LIMIT $ 1 000 000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached it more space is required) Re: Contractor License --See Attached Remarks Schedule -- CERTIFICATE HOLDER CANCELLATION City Of Fort Collins P.O. Box 580 330 S. College Ave. Fort Collins CO 80522-0580 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 / t Michael J. O'Neill ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 48580963 1 GRAYCOR 119/20 GL AL WC I Kathy Wilson 15/B/2019 3:20:20 PM (CDT) I Page 1 of 2 This certificate cancels and supersedes ALL previously issued certificates.