HomeMy WebLinkAboutGE JOHNSON CONSTRUCTION COMPANY INC - INSURANCE CERTIFICATEACORi CERTIFICATE OF LIABILITY INSURANCE
♦� �'
DATE(MMroDYYYq
10/42019
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 pollcy(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 endorsements .
PRODUCER
IMA, Inc: - Colorado Division
1705 17th Street, Suite 100
Denver CO 80202
NAME: IMA Denver Team
PHor+E 303-534 4567 FAY o
E-MAIL
ADORES : DenAccountTech6 imaco .com
'INSURER(S) AFFORDING COVERAGE
NAIL If
INSURER A: Charter Oak Fire Insurance Co.
25615
INSURED GEJOHNS
.INSURER a: Travelers Indemnity Company
25658
G.E. Johnson Construction Company, Inc.
Attn: Accounts Payable
INSURERc: Zurich American Insurance Co.
16535
INSURERD: Pinnacol Assurance
41IN
25 North Cascade Avenue, Suite 400
INSURER E: Zurich.American Insurance Company
16535
Colorado Springs CO 80903
INSURER F :
COVERAGES CERTIFICATE NUMBER:585401092 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.
ILTR
TYPE OF
I
Bli
POLICYNIIMBER
POLI
SCUFF
MM4)O/YV
POLI CCY EXP
MMlDDl1'YY
LINTS.
A
X
COMMERCIAL GENERAL LIABILITY
DTC00670C701COF19
10/1/2019
10/1f2020
,EACHOCCURRENCE
$2,000,000
CLAIMS -MADE � OCCUR
DAMAGE TO RENTF D
PREMISES Eaoccurrence
$1,000.000
X
MED EXP (Any one erson)
$ 5,000
PD.Ded: $5,000
X
XCU Cov Not Excl
PERSONAL 8 ADV INJURY
$2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$4,000,000
POLICY I I JEST I LOC
PRODUCTS - COMP/OP AGO
$ 4 000,000
$
OTHER:
B
AUTOMOBILE LIAeILITY
DT8100870C7011ND19
10/1/2019
10/1/2020
lE0aAlaSiINccidEDiSINGLELIMIT
$2;000;000
BODILY INJURY (Per person).
$
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Peraxidont)
$
PROPERTY DAMAGE
Par acddern
$
X HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
6
C
X
UMBRELLA LIAR X
OCCUR
AUC931908406
10/1/2019
10/12020
EACHOCCURRENCE
$10,000.000
AGGREGATE
$10,000,000
EXCESS LIAR I
I CLAIMS -MADE
DED I X I RETENTIONS n
$
D
E
WORKERSCOMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETOR/PARTNER/EXECUTIVE a
OFFICERIMEMBEREXCLUDEO?
(Mandatory In NH)
NIA
4048587
WC463293210
10/12019
10/12019
10/12020
10/12020
X STAT TE ER
E.L. EACH ACCIDENT
$1.000,000
E.L. DISEASE - EA EMPLOYEE
$1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
It 1,000,000
mscmPnON OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 161, Additional Remerke Schedule, may be attached If more apace Is requhed)
General Liability includes Wyoming Stop Gap.
Builders Risk Coverage: Policy #OT6606D044388TIL19
Effective Dates: 10101119-10101/20 Insurer: TRAVELERS PROP CAS CO OF AMER
$15,000,000 Frame/Joisted Masonry Limit; $100,000.000 All Other Construction;$100,000 Per Disaster
$60,000,000 Non -Combustible; $2,000,000 Temporary Location Limit;
$1,000,000 Transit Limit $5,000 Deductible SPC Form
$10,000,000 Earthquake Sub -Limit; $25,000 Deductible
See Attached...
CFRTIFICATF Mr71 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.
PO Box.580
AUTHORIZED REPRESENTATIVE
Fort Collins CO 80522 0000
USA
01968.2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
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