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Home My WebLink About481078 BRINKMAN CONSTRUCTION INC - INSURANCE CERTIFICATE (3)A(:UKUn. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6/1/2016 2/17/2016 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(ies) must 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 Lockton Companies 8110 E. Union Avenue .Suite 700 Denver CO 80237 NAM A/C No Ext : A C No E-MAIL ADDRESS: INSURER AFFORDING COVERAGE NAIC It (303) 414-6000 INSURERA: Allied World Specialty Insurance Company 16624 INSURED Brinkman Construction, Inc. 1392942 3528 Precision Drive Suite 100 Fort Collins, CO 80528an INSURER B : Depositors Insurance Company 42587 INSURER C : First MercuryInsurance Company 106 ws RER D : Pinnacol Assurance Company 41190 INSURERE: IN E 17171vPRA"PR rGDTICIr A7CId11M0C0. lgZVUAVV nnsnw�u w,. - vvvvvvv 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 TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF IMM/DDIYYYY POLICY EXP IMMIDDIYYYYLIMITS A X COMMERCIAL GENERAL LABILITY Y N 03094424 2/17/2016 2/17/2017 EACH OCCURRENCE 1,000,000 CLAIMS -MADE 0 OCCUR DAMAGE R AGESO RENTED cr nte 100,000 MED EXP (Any oneperson) 5,000 PERSONAL B ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2000000 POLICY �E0 LOC PRODUCTS - COMP/OP AGG $ 21000,000 OTHER B AUTOMOBILE LABILITY Y N ACP3017052062 2/17/2016 2/17/2017 COMBINED ISINGLE LIMIT $ 1 OOO OOO X BODILY INJURY (Per person) $ XXXXXXX ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident $ XXXXXXX HIRED AUTOS AUUTOSWNED PeOP.ER DAMAGE $XXXXXXX $XXXXXXX C UMBRELLA LAB I X OCCUR N N CA-EX-0000061794-01 2/17/2016 2/l7/2017 EACH OCCURRENCE $ 10.000000 X AGGREGATE $ 10,000,000 EXCESS LAB CLAIMS -MADE DIED I I RETENTION $ $ XXXXXXX D WORKERS COMPENSATION AND EMPLOYERS'LABILIITY YIN N 4093547 6/1/2015 6/1/2016 X STATUTE GTH E.L. EACH ACCIDENT $ 1,000,000 ANY OFFICER/MEMSER EXCLUD D7 EWEXECUTIVE N / A E.L. DISEASE. EA EMPLOYEE 1,000,000 (Me desy,n NH) If yes,s, ,fesuiee under E.L. DISEASE- POLICY LIMIT Is 1,000,000 DESCRIPTION OF OPERATIONS Delp DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins and Poudre Fire Authority, their officers, agents and employees are included as Additional Insured on general liability and auto liability as required by written contract with respects to liability arising out of work performed by the named insured. - 13359688 City of Fort Collins and Poudre Fire Authority P.O. Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD C All rinhte racamarl