HomeMy WebLinkAbout239190 GARNEY CONSTRUCTION - INSURANCE CERTIFICATEThis certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those Companies
LDI COI 268896 02 11
NM 772 07-10
Personal & Advertising Injury
GENERAL LIABILITY
NFORMATION ONLY AND CONFERS NO RIGHTS UP
INSURANCE POLICY AND DOES NOT AMEND, EXT
THIS CERTIFICATE IS ISS
This is to Certify that
NAME AND
ADDRESS
OF INSURED
is, at the issue date of this certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ies) is subject to all their terms,
exclusions and
Conditions and is not altered by any requirement, term or condition of any contract or other document with respect to which this certificate may be issued.
OFFICE PHONE DATE ISSUED
TYPE OF POLICY
EXP DATE
CONTINUOUS
EXTENDED
POLICY TERM
POLICY NUMBER LIMIT OF LIABILITY
WORKERS
COMPENSATION
RETRO DATE
OCCURRENCE
CLAIMS MADE
AUTOMOBILE
LIABILITY
OWNED
NON-OWNED
HIRED
OTHER
ADDITIONAL COMMENTS
* If the certificate expiration date is continuous or extended term, you will be notified if coverage is terminated or reduced before the certificate expiration date.
NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.)
BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT CANCEL OR REDUCE THE
INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST DAYS NOTICE
OF SUCH CANCELLATION HAS BEEN MAILED TO:
COVERAGE AFFORDED UNDER WC
LAW OF THE FOLLOWING STATES:
EMPLOYERS LIABILITY
Bodily Injury by Accident
Bodily Injury By Disease
Bodily Injury By Disease
Policy Limit
Each Person
Each Accident
Each Accident—Single Limit
Products / Completed Operations Aggregate
Other Other
Each Person
Each Accident or Occurrence
Each Accident or Occurrence
UED AS A MATTER OF I ON YOU THE CERTIFICATE HOLDER. THIS CERTIFICATE IS NOT AN
END, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW.
Certificate of Insurance
General Aggregate
Per Person / Organization
B.I. And P.D. Combined
Certificate
Holder
Liberty Mutual
Insurance Group
AUTHORIZED REPRESENTATIVE
POLICY LIMITS ARE NO LESS THAN THOSE
LISTED, ALTHOUGH POLICIES MAY INCLUDE ADDITIONAL SUBLIMIT/LIMITS NOT LISTED BELOW.
COMMERCIAL
Each Occurrence
✓
Stacy Spieker
9/15/2016
Overland Park / 0448
6800 College Blvd, Suite 700
Overland Park KS 66211-1123 913-681-1700
Garney Holding Company/Garney Companies Inc./
Grimm Construction Co. Inc./Garney Federal, Inc./
Encore Construction Group, Inc.
1333 NW Vivion Road
Kansas City MO 64118-4554
RE: Master Contract
City of Fort Collins
Purchasing Division
P.O. Box 580
215 North Mason Street, 2nd Floor
Fort Collins CO 80522
60
Named Insured, but only for the coverage and limits provided by the policy and the additional insured endorsement.
City of Fort Collins is an additional insured under the General Liability and Automobile Liability policy if required by a written contract with the
RE: Master Contract
10/1/2017 TB2-641-426942-726
$2,000,000
✓
$2,000,000
$1,000,000
$1,000,000
$300,000 Damage to Premises
Rented to You
$10,000 Medical Expense
10/1/2017 AS2-641-426942-716 $2,000,000
✓
✓
✓
10/1/2017 WA2-64D-426942-736
AL, AR, AZ, CO, FL, GA, IA, KS,
KY, LA, MO, MS, NC, NE, NM, OK,
SC, TN, TX, UT, VA, WV
Includes Coverage 3C, Other
States Insurance: All States
except those listed and the
states of ND, OH, WA, and WY.
$1,000,000
$1,000,000
$1,000,000
31776035 | LM_2660 | 10/16-10/17 - All Lines | Donna Smitala | 9/15/2016 10:01:28 AM (CDT) | Page 1 of 1