HomeMy WebLinkAbout250056 WYATT CONSTRUCTION CO INC - INSURANCE CERTIFICATE (5)74T
(MWDD/YYYY)
ACURO® CERTIFICATE OF LIABILITY INSURANCE
26/2018
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 CareyBu@n0 CISR
NAME:
Taggart and Associates, Inc {acNro Ex_• (303) 442-1484 No: (303)442-8822
1680 38th Street, Suite 110 ADD_Rees_s:cbueno@taggartinsurance.com
P . 0. Box 147 INSURERS AFFORDING COVERAGE NAIC S
Boulder CO 80306 INSURERA:Selective Way Insurance Co 26301
irvauneu INSURER B :
Wyatt Construction Co. Inc. INSURER C :
3223 Arapahoe Ave. Suite 100 INSURERD.,
Boulder CO 80303 1 INSURERF:
rrnvCeeccc rFRTIFIrATF NIIMRFR•18/19 Master 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 TYPE OF INSURANCE ADDL UBR POLICY NUMBER MMI �Y EFF MM/DCQYYY LIMITS
LTR
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
CLAIMS -MADE � OCCUR
PREMISES SES EaEoccurrence
$ 500,000
MED EXP (Any one person)
S2303197
5/1/2018
5/1/2019
$ 15,000
PERSONAL 8 ADV INJURY
$ 1,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
POLICY X JI PRO- `__ I LOC
JECT
$
OTHER:
AUTOMOBILE LIABILITY
COMBINE IN LE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY (Per person)
$
$
A
X ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
HIRED AUTOS AUTOS
S2303197
5/1/2018
5/1/2019
BODILY INJURY (Per accident)
PPRaOPPEER� DAMAGE
$
-
— - -
X
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 10,000,000
AGGREGATE
$ 10 000 000
A
EXCESS LIAB
CLAIMS -MADE
DED I X I RETENTION$ 0
$
S2303197
5/1/2018
5/1/2019
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
ER TH-
STATUTE ER
E.L. EACH ACCIDENT
$
OFFICER/MEMBER EXCLUDED? ❑
(Mandatory ir, NH)
N/A
E.L. DISEASE - EA EMPLOYEE_$
_
E.L. DISEASE - POLICY LIMIT
If yes, describe under
DESCRIPTION OF OPERATIONS below
$
I
I
�
�
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
GERTIFICATE
City of Fort Collins
PO 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.
AUTHORIZED REPRESENTATIVE
Carey Bueno/CMB tJ
U 1988-2014 AGUKU CUKF'UKA I IUN. All rlgnts reserVea.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
I NS025 (201401)