HomeMy WebLinkAboutWANER CONSTRUCTION COMPANY INC - INSURANCE CERTIFICATE (5)Ntnizsrxt
A ® DATE (MMIDD/YYYY)
A CERTIFICATE OF LIABILITY INSURANCE 02/27/2018
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 have ADDITIONAL INSURED provisions or 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 1-303-534-4567 CONTACT
NAME:
INA, Inc. - Colorado Division PHONE FAX
AAIC.NQ.EjQ1 _ '' (A/C.No):
E-MAIL demccountteclleQimacorp.cOm
1705 17th Street ADDRESS:
Suite 100 INSu S AFFORDING COVERAGE NAIC0__
Denver, CO 80202 INSURERA:VAL1 FOR(R INS CO (CNA) 20508
INSURED INSURERS: NATIONAL FIRS INS CO OF EARTFORD(CNA) 20478
Warier Construction Company, Inc. INSURER CCONTINENTAL INS CO (CNA) 35289
8950 Barron Blvd, Unit 103 INSURERD: PINNACOL A88UR 41190 -
INSURERE: TRAVZIMS PROF CAS CO OF AIRS 25674
Highlands Ranch, CO 80129 INSURERF:
nnv�nwn_oe reoTHICU ATe uuuaco- 52153234 RFVISIAN NIIMRFR-
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 ADDL SUER POLICY EFF POLICY EXP LIMITS
LTR TYPE OF INSURANCE POLICY NUMBER MMIDD/YYYY MWDD
A
X
COMMERCIAL GENERAL LIABILITY
2092449581
03/01/18
03/01/19
EACH OCCURRENCE
i 1,000,000
-
I�
CLAIMS -MADE U OCCUR
DAMAGEE T61TED
PREMISES Ea occurrence
--
= 300,000 -
X
MED EXP (Any one person)
FD Ded; $2, 000
$ 5,000
PERSONAL h ADV INJURY
= 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
t 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
_ POLICY PRO-
JECT 1XI LOC
$
OTHER:
B
AUTOMOBILELIABILIY
2092449595
03/01/18
03/01/19
COMBINEDSINGLELIMIT
Eaaccident
i 1,000,000
BODILY INJURY (Per person)
$
ANY AUTO
BODILY INJURY (Per accident)
f
OWNED SCHEDULED
AUTOS ONLY __ AUTOS
IX HIRED NON -OWNED
I AUTOS ONLY % AUTOS ONLY
—
PROPERTY DAMAGE
Per accident
--
$
_
C
X
iMIBRELLALIM
Z
OCCUR
2092449578
03/01/18
03/01/19
EACH OCCURRENCE
$ 2,000,000
AGGREGATE
EXCESSLIAB
CLAIMS -MADE
s a, 000, 000
DIED i % RETENTION 10, 000
=
D
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y I N
ANYPROPRIETORlPARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUE
(Mandatory In NH)
NIA
4107186
03/01/18
03/01/19
z PERT
STAR
E.L. EACH ACCIDENT
s 500,000
$ 500,000
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
= 500, 000
If yes, describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space In required)
Certificate Holder is included as Additional insured on the General Liability Policy if required by written contract or
agreement and with respect to work performed by Insured subject to the policy terms and conditions.
GtKIIrIUAIt KULUtK �,MIeI,CLL,91rV1�
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
PO BOX 580 AUTHORIZED REPRESENTATIVE MR
Fort Collins, CO 80522-0000 IISA
W 1V50-ZU1.1 AGUKU k UKYVKAI IUM. All r18nTs reserves
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
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52153234