HomeMy WebLinkAbout166269 GARNEY HOLDING CO - INSURANCE CERTIFICATE (21)DATE (MM(OD/YYYY)
C"R" CERTIFICATE OF LIABILITY INSURANCE
l`� 1 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 endorsements .
PRODUCER CONTACT
NAME:
Arthur J. Gallagher & Co. Insurance Brokers of CA. PHONE 415-391.1500 ac No : 415.391-18-
1255 Battery Street #450 &MAIL
82
San Francisco CA 94111
INSURER A: Liberty Mutual Fire Insurance Company 23035
INSURED GARNCOM-02 INSURERS: Travelers Property Casualty Co of America 25674
Garney Holding Company/Garnet' Construction -
1Garney Pacific, Inc aGarney Federal, Inc. INSURER:
W — -
1333 NVivion Road INSURER 0:
Kansas City MO 64118 INSURER E:
COVERAGES CERTIFICATE NUMBER: 1658132314 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 LTR TYPEOFINSURANCE POLICY NUMBER A'O fDDIYV MMOD/YYY Lam
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS•MAUE OCCUR
Y
Y
TB2641426942729
1011Y2019
1011/2020
EACH OCCURRENCE
$2.000.000
PREMISES Me Ec urr n
$300,000
MED EXP lAny oneperson)
$10,000
PERSONAL & ADV INJURY
s2,000.000
GFN'L AGGREGATE LIMIT APPLIES PER:
POLICY X jEpT LOC
OTHER:
GENERAL AGGREGATE
$4,000,000
PRODUCTS -COMP/OP AGO
$4,000,000
6
A
AUTOMOBILE LIABILITY Y Y AS2641426942719
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
X HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
10/1/2019
101112020
aBINEDSINGLELIMIT
$2,000,000
BODILY INJURY (Per person)
6
BODILY INJURY (Per accident)
S
PROPERTY DAMAGE
Per 'da'
S
$
B
X UMBRELLALIM
EXCESS UAB
X
OCCUR
CLAIMS -MADE
ZUP14S7845219NF
10/1/2019
10/112020
EACH OCCURRENCE
$15,000.000
AGGREGATE
$15,000,000
S
DEC RETENTIONS
A
A
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY YIN
ANYPROPRIETORoARTNEREXECUTIVE ❑
Po OFFICEMEMBER EXCLUDED?
(Mandatory In NH)
II yes, c1mcnbe under
DESCRIPTION OF OPERATIONS babes
MIA
Y
WA264D426942739
WC2641437723909
10/1/2019
101112010
1011/2020
10/1/2020
XPE OTH.
A TE ER
_
$1,000,000
81,000,000 --
a 1,000,000
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addltlonal Remarks Schedule, may be attached It more space Is requlred)
RE Gamey Job #6248 2D, Bozelder Creek Outdall - Overflow Channel and Urban Design Features The City of Fort Collins and Andersen Consulting
Engineers are additional insured with regards to general liability and automobile liability, as their interest may appear. where required by written contract
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
ACCORDANCE WITH THE POLICY PROVISIONS.
4316 LaPorte Avenue
AUTHORIZED REPRESENTATIVE
�' 7
Fort Collins CO 80522
USA✓//.
C6 1968-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
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