HomeMy WebLinkAbout166269 GARNEY HOLDING CO - INSURANCE CERTIFICATE (18)orro� CERTIFICATE OF LIABILITY INSURANCE
DATE (MM;DD:YYYY)
9/29/2019
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 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:
Arthur J. Gallagher & Co. Insurance Brokers of CA. PHONE FAX -
1255 Battery Street #450 • 415-391-1500 AIc No): 415-391-1882
E-MAIL
San Francisco CA 94111 ADD_RESs: _
INSURED
Garvey Holding Company/Garney Construction
/Garvey Pacific, Inc./Gamey Federal, Inc.
1333 NVV Vivion Road
Kansas City MO 64118
COVERAGES CERTIFICATE NUMBER:973790749 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.
INSR-. -- POLICYEFF POLICCY EXP
LTR TYPE OF INSURANCE I WV POUCYNUMBER MM/DD'VYYV MM/DDIYYY LIMITS
A
X
COMMEROALGENERALLIABILITY
Y
Y
TS2641426942729 10/1/2019 10/112020 1 EACH OCCURRENCE
$2,000,000
CLAIMS -MADE � OCCUR
RENTED
j PRE�6�M9ES Ea occurrence
$300.000
$10.000
MED EXP (Any one person)
s2,000.000
PERSONAL& ADV INJURY
GEN'L AGGREGATE LIMIT APPLIES PER:
$4,000,000
GENERAL AGGREGATE
POLICY 7 LOC
PRODUCTS-COMP/OP AGG
$4,000,000
$
OTHER
A
AUTOMOBILE LIABILITY
Y
Y
AS2641426942719
1011/2019
10/1/2020 COMBINEDSINGLE LIMIT
Ea ec Aden
112.000,000
X ANYAUTO
BODILY INJURY (Per person)
B
OWNED SCHEDULED
_ AUTOS ONLY AUTOS
X AUTOS ONLY x AUTOS ONLY
BODILY INJURY (Per accident)
i_72C$ccid nDAMAGE
S
_
S
X
UMBRELLALIAB
X
OCCUR
ZUP14S7"5219NF
1011/2019
10/1/2020 EACHOCCURRENCE
$15,000,000
$15.000.000
EXCESS tJAB
CLAIMS -MADE
AGGREGATE
DED RETENTIONS
8
A
A
WORKERSCOMPENSATION
AND EMPLOYERs'LIABILRY Y/N
ANYPROPRIETORPARTNEREXECUTIVE ❑
OFFICERIMEMBEREXCLUOED7
(Mandatory In NM
N/A
Y
WA264D426942739
WC2641437723909
10/l/2019
10/1/2019
10/112020
10/112020
X ATIJTE ERM.
E.L. EACH ACCIDENT
$1,000,000
$1,000,000
E.L. DISEASE - EA EMPLOYEE
It yes, describe under
DESCRIPTION OF OPERATIONS bebw
51000000
E.L. DISEASE -POLICY LIMIT
I
DESCRIPTION OF OPERATIONS +LOCATIONS VEHICLES (ACORD 101. Additional Remarks Schedule, maybe attached If more apeoe Is required)
RE Gamey Job #6248, Boxelder Creek Outfall Phase 2A Overflow Channel and Culverts City of Fort Collins and Andersen Engineering Consultants are
additional insured with regards to general liability and automobile liability, as their interest may appear, where required by written contract. Waiver of
Subrogation is included in favor of the certificate holder, and applies only to the specific jobs of the insured performed under written contract, and where
applicable by law.
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
/
t
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
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