HomeMy WebLinkAboutGAMMA CONSTRUCTION COMPANY - INSURANCE CERTIFICATE (3)AC"R"DATE
`.///__ CERTIFICATE OF LIABILITY INSURANCE
(MM/DD)
12,22,2015015
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 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
Tucker Agency, Ltd.
P O Box 2285
Ft. Worth TX 76113
CONTACT Roberta Erb
NAME:
PHONE (817)336-8520 A/CNo:(FA 817)336-6501
EA -MAIL .roberta@tuckeragency.com
INSURERS AFFORDING COVERAGE
NAIC #
INSURERA:Zurich American Insurance Co.
INSURED
Gamma Construction Company
P 0 BOX 22047
Houston, TX 77227
INSURERB:TraVelers Property & Cas. Co.
INSURER C
INSURERD:
INSURERE:
INSURER F :
COVERAGES CFRTIFICATF NIIMRFR:15/16 All Lines 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
LTRWVD
TYPE OF INSURANCE
ADDL
UBR
POLICY NUMBER
LICY EFF
MM/DDlYYYY
POLICY EXP
MM! D/YYYY
LIMITS
A
GENERAL LIABILITY
OMERCIAL GENERAL LIABILITY
CLAIMS -MADE � OCCUR
tX—X]MCU Included
X
X
LO 3981716-13
12/31/2015
12/31/2016
EACH OCCURRENCE
$ 1,000,000
DAMAGE T RENTED
PREMISES Ea occurrence
$ 300 000
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,000
X
Contractual
GENERAL AGGREGATE
$ 2,000,000
GE N'L AGGREGATE LIMIT APPLIES PER:
POLICY X PRO LOC
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
A
AUTOMOBILE LIABILITY
X ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
X HIRED AUTOS X AUTOS
X
X
BAP 3981717-13
12/31/2015
12/31/2016
Ee aBINEDtSINGLE LIMIT
1,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
B
X
UMBRELLA LAB
EXCESS LAB
X
OCCUR
CLAIMS -MADE
X
X
UP-91M48632-15-NF
12/31/2015
12/31/2016
EACH OCCURRENCE
$ 25,000,000
AGGREGATE
$ 25,000,000
DED RETENTION $ 10,000
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y!N
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
X
C 3981718-13
12/31/2015
12/31/2016
X WC ORYLIMT OH-
S
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
I $ 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
Re: Contractors License #A-84
UtK I IFIC:A I It HULUtK V1MI1`Il11=L L-M I IVIY
City of Fort Collins
P 0 Box 580
Fort Collins, CO 80522-0580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2010/05)
INS025 (201005) 01
—
Tracy Tucker/RE
V 19t3t3-Zu1U ACUKU GU111-UKA I IUN. All rlgnis reservea.
The ACORD name and logo are registered marks of ACORD