HomeMy WebLinkAboutBEMAS CONSTRUCTION INC - INSURANCE CERTIFICATE (2)CERTIFICATE OF LIABILITY INSURANCE
DATE (MM7DOYYYY)
10/112019
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: It 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 """M"'�'
NaME: IMA Denver Team
IMA, Inc. - Colorado Division PHONE- FAX
1705 17th Street, Suite 100 • 303-534.4567 fA.C. No:
Denver CO 80202 AD RESS: DenAccountTechenimacorp.com
INSURERS) AFFORDING COVERAGE-- NAIC
INSURED BEMAGON msuRER a: Liberty Insurance Corporation 42404
Bemas Construction, Inc. 80 Inverness Drive East INSURERc: Pinnacol Assurance 41190
-- —
Englewood CO 80112-5114 INSURERD:
CC.VFRAGFS CERTIFICATE NUMBER :229018344 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 REOUIREMENT, 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.
IN SR MLOFINSURANCE _. T�LppY� �B —_
YIV POUCYNUmBEF1 D7YV
A
X
COMI111-ALGENER�ALLIABILITY
CLAIMS -MADE `X OCCUR ��
TB2Z91463096029
9130/2019
9130/2020 LEACHOCCURRENCE
•_PREMI E Ea =rrene
$1.000,000
$100.000
X
i SA00
BIIPD Ded•S10000 -
MED EXP (Anyone person)
$1,000,000
PERSONAL& ADV INJURY
GEN'L AGGREGATE LIMIT APPLIES PER:
$2,000,000
GENERAL AGGREGATE
$ 2.000,000
POLICY T JEST 7 LOC
PRODUCTS - COMPIOP AGO
6
OTHER:
A
AUTOMOBILELIABIIJTY
AS2Z91463096018
9130I2019
9/3020208dINdFD INGLE LIMIT
$1,000,000
6
X I ANY AUTO
BODILY INJURY (Par person)
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
X AUTOS ONLY X AUTOS ONLY
BODILY INJURY (Par aocirbntl
I PROPERTYDAMAGE
Per agggent
8
$
E
e
X
UNBRELLALIAB
X
OCCUR
TH7Z91463096039
9l30I2019
91302020 EACH OCCURRENCE
$10,000,000
$10,000,000
EXCESS LIAB
CLAIMS -MADE
AGGREGATE
DEC X RETENTIONS
O
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANYPROPRIETORPARTNER/EXECUTIVE YIN
OFFICER'MEMBEREXCLUDED?
(Mandatory In NH)
N/A
4032634
111112111 1/1/112020
PER
X ISTAT TE ER
E.L. EACH ACCIDENT
$1,000,000
-
$1,000,000
E.L. DISEASE EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
If yes. describe under
DESCRIPTION OF OPERATIONS Oebw
$1,000.000
A Physical Damage
I
AS2Z91463096019 9/30/2019 9130/2020 ComprehemWe
Collision
$1,000
$1,000
DESCRIPTION OF OPERATIONS 'LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is requbed)
`General Liability shall be applicable to offsite coverage subject to the terms and conditions of the policy. if required by written contract or agreement.
'Perthe policyterms and conditions, XCU IS NOT EXCLUDED FROM CONTRACTORS LIABILITY
Pollution Liability Coverage: Policy # MP19ECP3004051C
Effective Dates 09/30119-09130/21 Insurer: Navigators Specialty Insurance Company
$5,000,000 Per Occurrence; $5.000,000 Aggregate; $25,000 Deductible
Retro Date: 09/30/09 Site Pollution
See Attached...
CFRTIFICATF HOI-nFR CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins
ACCORDANCE WITH THE POLICY PROVISIONS.
287 North College Avenue PO Box 580
AUTHORIZED REPRESENTATIVE
Fort Collins CO 80522-0580
USA
//!
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ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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