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Home My WebLink About113752 BT CONSTRUCTION - INSURANCE CERTIFICATE (19)ACORD,CERTIFICATE OF LIABILITY INSURANCE mnnozo DATE 9/12/DDIYYYV) 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 NAM A1C No Ert : A/C No); 8110 E Union Avenue Suite 700 Denver CO 80237 E-MAIL ADDRESS: INSUREFUSI AFFORDING COVERAGE (303)414-6000 INSURER A: The Phoenix Insurance Company 25623 INSURED BT Construction, Inc. INSURERS: Tr&vdc.4opWyCasuallyC00fAmerica 25674 1312924 9885 Emporia Street Henderson, CO 80640 INSURER C : INSURER INSURER E INSURER F CnVFRArFS RTromol CFRTiFICATI-NIIMIRFR• 1 Ail RAIDS REVISInN N1UuRER: 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. INSR LT TYPE OF INSURANCE ADM I UBR POLICY NUMBER POLICY EFF MM D P061CY E P D LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Y N OT-CO-4H983410-PHX-19 10/1/2019 10/1/2020 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED PREMISES Ea m rren 3OO OOO MED EXP (Any oneperson) 5,000 PERSONAL & ADV INJURY s 1 OOO OOO GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JET LOC OTHER: GENERAL AGGREGATE s 2 o0O 000 PRODUCTS -COMP/OPAGG s 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO OW1TOS ONLYMSCHEDULED HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Y N 810-6N339174-19-26-G 10/1/2019 10/1/2020 (Ea accident) COMBINED SINGLE LIMIT s 1000000 X BODILY INJURY (Per person) $ XX)C)CX Qt BODILY INJURY (Per accident $ XXj)Q(}Q{ X PROPERTY DAMAGE d S XXXXXXX a XXXXXXX B X UMBRELLA LIAB EXCESS LUIB }N OCCUR CLAMS -MADE Y N CUP-SJ518965-19-26 10/1/2019 10/1/2020 JEACH OCCURRENCE s 10000000 AGGREGATE $ 10,000,000 DED RETENTIONS $ XXXXXXX H WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERAIEMBER EXCLUDED? R/yytaanaadol ry In NH) 0 RIPT ON O OPERATIONS W. NIA N UB-6J84757A-19-26-G 10/1/2019 10/1/2020 X I STATUTE O E.L. EACH ACCIDENT S 1000,000 E.L. DISEASE - EA EMPLOYEE 1,000,000 E.L. DISEASE - POLICY LIMIT 1 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be anached If more space le required) RE: Job #64040 - City of Fort Collins Hickory Street 2019 Water Improvements. The City of Fort Collins its officers, agents and employees are included as Additional Insured as respects General Liability, Excess Liability, and Automobile Liability if required by written contract. If the Policy is cancelled by the issuing company during the policy term, for other than non-payment of premium, 30 days notice will be provided to the certificate holder named below, 10 days for non-payment of premium. 16186355 The City of Fort Collins 300 LaPorte Ave 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. All rights reserved The ACORD name and logo are registered marks of ACORD