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HomeMy WebLinkAboutBRB CONTRACTORS INC - INSURANCE CERTIFICATE (6)ACORL7® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) �....-� 3/24/2016 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 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 endorsements . PRODUCER CONTACT NAME: Certificate Department TRUSS 4551 W. 107th St., Third Floor PHONE A/C Moll; 913.491.6379 . 913.341.8998 E-MAIL Certificates@TrussAdvantage.Com Overland Park KS 66207 INSURERS AFFORDING COVERAGE NAICIf INSURER A :Travelers Property Casualty 25674 INSURED INSURER B :Amerisure Insurance Company 19488 BRB Contractors, Inc. INSURERC:Amerisure Mutual Ins Co 23396 3805 25 Street TopK Topeka KS 66618 INSURER D :Columbia CasualtyCo. CNA 31127 INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: 668076416 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 LTR TYPE OF INSURANCE ADDLSUEIR INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY Y GL20753590401 4/1/2016 4/1/2017 EACH OCCURRENCE $1,000,000 CLAIMS -MADE �� OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $100,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRO - POLICY X JECT LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OPAGG $2,000,000 $ OTHER B AUTOMOBILE LIABILITY Y CA20753500602 4/1/2016 4/1/2017 M SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO ALL AUTOS AUTOS OWNED AULED BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PR PERTY DAMAGE Per accident $ A X UMBRELLA LIAB X OCCUR ZUP41M0096115NF 4/1/2016 4/1/2017 EACH OCCURRENCE $20,000,000 AGGREGATE $20,000,000 EXCESS LIAB CLAIMS -MADE DED I X I RETENTION $ -0- $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑N N / A WC207534903 4/1/2016 4/1/2017 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE — $1,000,000 (Mandatory in NH) If yes, daacrThe under DESCRIPTION OF OPERATIONS below — E.L. DISEASE -POLICY LIMIT $1,000,000 A D Builders Risk Contractors E&O/Pollution QT6307644B708 2076178830 4/1/2016 4/7/2016 4/1/2017 4/7/2017 Limit "'SEE BELOW" Ded 2,500 Poll Lmt Claim/Agg 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) v. - r k.AIYI.CLL.A I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN James O'Neill, CPPO, FNIGP, City of Fort Collins, ACCORDANCE WITH THE POLICY PROVISIONS. Director Purchasing & Risk Mgt 215 North Mason St., 2nd Floor AUTHORIZED REPRESENTATIVE Fort Collins CO 80524 av-) © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD