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HomeMy WebLinkAbout250056 WYATT CONSTRUCTION INC - INSURANCE CERTIFICATE (2)ACoRL> CERTIFICATE OF LIABILITY INSURANCE TE DA4/25/DD019 4/25/2019 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 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 Taggart and Associates, Inc 1680 38th Street, Suite 110 P. O. BOX 147 Boulder CO 80306 CONTACT NAME: Carey Bueno FX aCNo Ext: (303)442-1484 A/C No; (303)442-8e22 ADDREAIL SS: cbueno@taggartinsurance.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Selective Way Insurance Co 26301 INSURED Wyatt Construction Co. Inc. 3223 Arapahoe Ave. Suite 100 Boulder CO 80303 INSURER B INSURERC: INSURER D: INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER:19-20 Master 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 MAYBE 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 MM/DDIYYYY POLICY EXP MM/DDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE —ffAMAGE —TO $ 1,000,000 A CLAIMS -MADE �X OCCUR PREM SES (Ea occurrence) $ 500,000 MED EXP (Any one person) $ 15,000 S2303197 5/1/2019 5/1/2020 PERSONAL & ADV INJURY $ 1,000,000 GENIAGGREGATE LIMITAPPLIES PER GENERAL AGGREGATE $ 2,000,000 PRODUCS - COO 2,000,000 X ❑ PRO- POLICY JF—�LOC Employee Benefits Each Employee $ 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ A X ANY AUTO OWNED ALL OWSCHEDULED AUTOS AUTOS NON -OWNED HIREDAUTOS AUTOS S2303197 5/1/2019 5/1/2020 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ Medical payments $ 5,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 10,000,000 HxCLAIMS-MADE AGGREGATE $ 10,000,000 A EXCESS LIAB DED I X RETENTION $ 0 $ S2303197 5/1/2019 5/1/2020 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE PER OTH- STAT UTE ER E.L. EACH ACCIDENT $ E.L_DISEASFI EA EMPLOYEE $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A L DISEASE -POLICY LIMIT es, describe under U$ SCRIP'IION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION City of Fort Collins 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 y Bueno/BEH © 1988-2014 ACORD CORPORATION. All riahts reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (20I401)