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HomeMy WebLinkAbout113752 BT CONSTRUCTION - INSURANCE CERTIFICATE (18)ACORDO, CERTIFICATE OF LIABILITY INSURANCE lo;v2o2o DA9/12/2019 Y) 9/12/2019 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(les) 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 Lockton Companies CONTACT NAME: PHONE A A/C No Eel: AIC No: 8110 E Union Avenue Suite 700 Denver CO 80237 E-MAIL ADDRESS NsAFFORDING RANAIC III (303)414-6000 INSURER A: The Phoenix Insurance Company 25623 INSURED BT Construction,Inc. INSURER B: Travelers Property Cwaty Co of Ants 25674 1312924 9885 Emporia Street Henderson, CO 80640 INSURER C : INSURER INSURER E INSURER F CcrvFRAr,Fs RTCON01 CERTIFICATE NUMBFR: 14121074 REVISION NUMBER: XXXXXXX 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. IILr1T.4RR TYPE OF INSURANCE ��INSD WIM SUBR POLICY NUMBER POLICY EFF PM 1 LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Y N DT-CO-4H983410-PFIX-19 10/1/2019 10/1/2020 EACH OCCURRENCE 1,000,000 PREMIC'ESORENTEcotmr 300000 MED EXP (Any one arson 5,000 PERSONAL B ADV INJURY $ 1,000,000 GENL AGGREGATE LIMIT APPLIES PER. POLICY a JET FX7 LOC OTHER: GENERAL AGGREGATE s 2 OOO OOO PRODUCTS - COMP/OP AGG s 2,000,000 S $ AUTOMOBLE LIABLr1Y ANY AUTO ONLY ALITOSULED X AUO60NED Y N 810-6N339174-19-26-G 10/1/2019 10/1/2020 COMBINEDSINGLELIMIT s ] OOO OOO BODILY INJURY (Per person) sAUTOS BODILY INJURY (Per accident s XXXXXXXHIRED I (Per acadent) PROPERTY DAMAGE $ XXXX)( EJIXXXXXX B )( UMBRELLA LULB EXCESS UAB OCCUR CLAIMS -MADE Y N CFJP-8J518%5-19-26 10/1/2019 10/1/2020 EACH OCCURRENCE E 10 000 000 [I AGGREGATE $ 10 000 000 DED RETENTION s S XXXXX3 x B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N OMY FFICER?.IEMBOR EXCLUDRR ECUTIVE N❑ (Myendmaq In NH) If DESCRIPTION OF OPERATIONS Wow N / A N UB-6J84757A-19-26-G 10/I/2019 f0/1/2020 X sinnrrE o a E.L. EACH ACCIDENT E 1000 000 EL DISEASE - EA EMPLOYEE 1000000 E.L. DISEASE- POLICY LIMIT 1 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) RE: 63984 - Fossil CreekBNSF Pedestrian Tunnel. The City of Fort Collins is included as Additional Insured as respects General, Auto, and Umbrella Liability as required by written contract. CtK I It-ICA I t KULUCK LEA UIZLLAI IUN JCU ALwunrllenLS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 14121074 AUTHORIZED REPRESENTATIVE The City of Fort Collins, Colorado 4316 LaPorte Avenue Fort Collins, CO 80522 ACORD 25 (2016103) ©1988-20. 5 ACORb CORP RATION. All rights reserved The ACORD name and logo are registered marks of ACORD