HomeMy WebLinkAboutGARNEY HOLDING COMPANY - INSURANCE CERTIFICATE (5)11
A� br CERTIFICATE OF LIABILITY INSURANCE
MINIM NYM
�` 9/29/20019
9
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(% AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: N 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 requirer an endorsement A statement on
this certificate does not confer rights to the certificate holder in lieu of such.endorsemen s)..-.
PRODUCER
ArthurJ. Gallagher &.Co. Insurance Brokers of CA.
1255 Battery Street #450
San Francisco CA 94111
CORTzar-
NAME:
PHONE 415-391-1500 a No : 415 391 1682....__
EXIII
_ _.....__ _. _. .
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INSU S AFFORDINTICOVERAGE
NAIL R_
DL4URERA: Liberty Mutual Fire Insurance Company -
.23035 .
INSURED C-ARNCOM-02
Gamey Holding Company/Gamey Construction
!Gamey Pacific, Inc./Gamey Federal, Inc.
1333 NW Vivion Road
Kansas City MO 64118
.
INSURER B:.Travelers Property Casualty Co of America
25674
INsuRERc:
INSURER0:
INSURER E:
INSURER F : . .
r•nvene15e1M roRTICIrATIM AMIURr.R:n7aA')sASc RFVISIDN NIIMRFR-
THIS IS TO CERTIFY THAT THE;POUCIES 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,
EXCPOLICIES- AND CONDITIONS OF SUCH POLICILIMITS SHOWN MAY HAVE BEEN REDUC�EyD BY PAID CLAIMS.
L.TTRp
TYPEOFUSURANCE. .- -
t00t
R
... .'. POUCYNUMBER
LCY
�Y�
UMTS.
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FXI OCCUR
Y
Y
TB2041426942729
-
1042019
10/12020.
-
EACH OCCURRENCE
S2,000,000.
DAMAGE TO RENTED
PREMISE occurrence)
$300,000
MEO EXP ( arePerson)
S 10,000 .
PERSONAL &ADV.INJURY
$2,000,000
GEN'L AGGREGATE LIMIT APPLES PER:
POLICY a. JEC ❑ LOC
OTHER:
GENERAL AGGREGATE
$4,000,000
PRODUCTS- COMP/OP AGO
S000,000
$
'A
AUTOMCBELELEAauJTY-
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS.
X I T_XUTSL
AUOSONLY AUTOONLY
-Y
Y
AS2641426942719
- 16/12619
10/12020
BINaINsotSINGLEIIMI -
$2.000.000
BODILY INJURY (Par. person)
S
BODILYINJURY.(Peracdet)
$
.
eaccrRaAMAGE
(Per dnl
y
S
-X
UMBRELLA LIAB
EXCESS 11AB
X
OCCUR
I CLAIMS -MADE
ZUP14S7845219NF -
10/12019
10/12020
-
EACH OCCURRENCE -
�$.15.000.000
I
AGGREGATE
$15,000.000,
DED I RETENTIONS
$
A
A
WORKEHSCOMPENSATION
AND EMPLAYERS' LIABILITY YIN
ANYPROPRIETORIPARTNER/EXECVTIVE ❑
OFRCERtMEMBEREXCLUDEDT
Mandatory GN10"
11 yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
Y
WA264D426942739
WC2641437723909
10/12019
10/12019
10/12020
10/12020
X STATUTE ER
EL. EACH ACCIDENT
$1,000,000
E.L. DISEASE-EAEMPLOYE�
$1,000,000
E.L. DISEASE -.POLICY LIMIT.
$1,000 000.
DESCRIPTION OF OPERATIONS I LOCATIONS / vEHICLES (ACORD 101, Additional Remelhs ScMdula, may ue atteehad N more space Is required)
RE: Job #6290 Boxelder Creek Outfall Phase 5 Plant Watering and Upper Channel Weed Control City of Fort Collins and Anderson Consulting Engineers are
additional insured viitil regards to general liability and automobile liability, as their interest may appear, where required by written contract.
c179rTIFICATC unE nFR CANCFLLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE.
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort 'Collins, Colorado
ACCORDANCE WITH THE POLICY PROVISIONS.
4316 LaPorte Avenue
AUTHORIZED REPRESENT TWE
Ale
Fort Collins CO 80522 -
USA
.01988-2015 ACORD CORPORATION. All rights,reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
5(r of 81 47.42