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168787 GOLDEN TRIANGLE CONSTRUCTION INC - INSURANCE CERTIFICATE (20)
Client#: 33463 GOLTRIPC ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)12131/2015 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 CONTACT NAME: _ Holmes Murphy -Colorado a/Co No E,�:515 223-6800 A/C No: 7600 East Orchard Rd, Ste 330 E-MAIL ADDRESS: South INSURER(S) AFFORDING COVERAGE NAIC # Greenwood Village, CO 80111 ....RERA Charter Oak Fire Insurance Comp 25615 INSURED Golden Triangle Construction, Inc 700 Weaver Park Rd Longmont, CO 80501 INSURER B : Starr Indemnity & Liability Com 38318 INSURER C : Travelers Casualty Insurance Co 19046 INSURERD: AGCS Marine Insurance Company 22837 INSURER E : Travelers Property Casualty Co. 125674 rr)\/FRArFC r F:PTIFIr:ATF NIIMRFR• 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 CONTRACTOR 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 INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 51OCCUR _ DTCO2F66716215COF 12131/2015 12/31/2016 EACHOCCURRENCE $1000000 CCCURRENCE ER PEMISES?ER, oNccTur ence $300 OOO MED EXP (Any one person) s5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO LOC PRODUCTS - COMP/OP AGG $2,000,000 $ E AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS X AUTOS DT8102F66716215TIL 12/31/2015 12/31/201 Ea aBcl (COMBINEDSINGLE LIMIT 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ B UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 1000022396 12/31/2015 12131/2016 EACH OCCURRENCE $10 000 000 X AGGREGATE $10 000 000 DED X RETENTION $0 $ C D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/ N OFFICER/MEMBER EXCLUDED? 7 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Leased/Rented Equ Scheduled Equip Install Floater N / A DTSUB3F02060416 MX193070611 1/01/2016 12/31/2015 01/01/2017 12131/2016 X I VYC STATU- OTH- E.L. EACH ACCIDENT $1 000 000 E.L. DISEASE - EA EMPLOYEE $1 000 000 E.L. DISEASE -POLICY LIMIT $1,000,000 100,000 less 5,000 ded ACV, less 5,000 ded 100,000 less 5,000 ded DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Contractors License City Of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 215 N. Mason ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 Fort Collins, CO 80524 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S176472/M174118 ATEC1