HomeMy WebLinkAbout166269 GARNEY HOLDING CO - INSURANCE CERTIFICATE (16).4C - CERTIFICATE OF LIABILITY INSURANCE
DATE (MWDD YYYY)
9/2912019
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 CONTACT
. NAME:_
AtC. No -
Arthur J. Gallagher & Cc Insurance Brokers of CA. PHONE 415-391-1500 415-391-1882
1255 Battery Street #450 -MAIL
San Francisco CA 94111 ADDRESS: I
INSURED
Garney Holding Company/Garney Construction
/Garney Pacific. Inc /Garney Federal, Inc.
1333 NVV Vivion Road
Kansas City MO 64118
Insurance Company
Casualty Co of America.
COVERAGES CERTIFICATE NUMBER:1703342814 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.
ILNTBIRI TYPE OPINBURARCE ADDUSU11- ---- -' POLICY EFF POLICY EXP ----- --------- -- —
POUCYNUMBER ML4'DD'YYYY MM1DD1VYY LaaTS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE I OCCUR
Y
Y
TB2641426942729
10/1/2019
10/1/2020
EACH OCCURRENCE
$2,000,000
PREMISES (E4 occurrence
$300,000
MED EXP (Any one person)
$10,000
PERSONAL &ADV INJURY
$2.000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY IKECT LOC
J
OTHER:
GENERAL AGGREGATE
$4,000,000
PRODUCTS - COMP/OP AGG
S 4.000,000
$
A
AUTOMOBILELLABILITY
jX ANY AUTO
OWNED SCHTOSEDULED
AUTOS ONLY AU
X HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
V
Y
AS2641426842719
10/1/20
ED SINGLE LIMIT
aod n
$2,000,000
BODILY INJURY (Per person)
6
BODILY INJURY (Per aooiaccident)S
PROPERTY DAMAGE
Per
S
S
8
X UMBRELLALGB X OCCUR
EXCESS IJM -MADE CLAIMS
ED ! RETENTIONS
pD
ZUP14S7845219NF
1
10/12019
10/1/2020
EACH OCCURRENCE
$15,000.ODO
AGGREGATE
$15,000,000
S
A WORKER5COMPENSATION
A AND
ROPRIEEMPLOYERSPART ER/ Y/N
OFFICE rMEMBRlPARTNER/EXECUTIVE ❑
RE%CLUDEDT
(Mandatory In NH)
(Mandatory
II yes. describe under
DESCRIPTION OF OPERATIONS below
N/A
Y
WA264D426942739
WC2641437723909
10/12016
10/12019
10/12020
10/12020
ll
X AT TE R
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA EMPLOYEE
$1,000.DOD
E.L. DISEASE • POLICY LIMIT
$1.000.000
DESCRIPTION OF OPERATIONS i LOCATIONS! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more apace Is required)
RE Master Contract City of Fart Collins is an additional insured under the General Liability and Automobile Liability policy if required by a written contract with
the Named Insured, but only for the coverage and limits provided by the policy and the additional insured endorsement.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins, Purchasing Division
ACCORDANCE WITH THE POLICY PROVISIONS.
P.O. Box 580
215 North Mason Street, 2nd Floor
Fort Collins CO 80522
USA
AUTHORIZED REPRESENTATIVE
® 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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