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HomeMy WebLinkAbout166269 GARNEY CO - INSURANCE CERTIFICATE (17)A� O® CERTIFICATE OF LIABILITY INSURANCE D/YYYY) F9/28/2017 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 endorsements . PRODUCER Arthur J. Gallagher Risk Management Services, Inc. 2345 Grand Blvd., Suite 400 Kansas City MO 64108 CONTACT NAME: Carolyn Short PHONE Ext) 816 395 8558 SAXc. 816 467-5558 E-MAIL carol n short@a com ApDRES. Y — Jg• __.___--__,. INSURER(S) AFFORDING COVERAGE NAIC N INSURER A: Travelers Property Casualty Co of America 25674 INSURED GARNCOM-01 INSURER B : _ INSURERC: Garney Holding Company (See attached list of Additional Named Insureds) 1333 NW Vivion Road wsuRERD: INSURER E : Kansas City MO 64118 INSURER F : COVERAGES CERTIFICATE NIIMRFP- 531779840 REVI-glnN 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. LTR TYPE OF INSURANCE INSD I WVD I POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYY - — LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ PREMISES�Ea occurrence REMIS_ TtLE@,oc tare- $ MED EXP (Any one person) $ GEN'L FOTHER: PERSONAL & AD_V INJURY $ AGGREGATE LIMIT APPLIES PER: POLICY 71 PRO- JECT LOC GEN_ER_ALAGGREGATE $ PRODUCTS E E AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED - NON -OWNED AUTOS ONLY AUTOS ONLY Ea_acciden[ $ BODILY INJURY (Per person) E BODILYINJURY (Per accident) $ OPERTYDAMAGE— _ APer accident)__ $ A X UMBRELLA LIAB EXGESSLIAB X OCCUR CLAIM_S-MADE Y Y ZUP-14S78452-17-NF 10/1/2017 1011/2018 EACH OCCURRENCE $15,000,000 AGGREGATE_ $15,000,000 DEDTX7 RETENTION $ None T $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) It yes, describe under DESCRIPTION OF OPERATIONS below NIA I PER STATUTE FOR -� E.L. EACH ACCIDENT E' --- $ E.L. DISEASE - EA EMPLOYEE E E.L. DISEASE - POLICY LIMIT E i I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) See Attached... t;LH I IFIGA 1 E HL)LULH CANCLLLA I ION City of Fort Collins P.O. Box 580 215 North Mason Street, 2nd Flolor 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. AUTH RIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: GARNCOM-01 LOC #: A�REP ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Arthur J. Gallagher Risk Management Services, Inc. NAMED INSURED Garney Holding Company (See attached list of Additional Named Insureds) 1333 NW Vivion Road Kansas City MO 64118 POLICY NUMBER CARRIER 7NAICODE EFFECTIVE DATE: UI I IUNAL KtMAKKJ THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE For the following additional Named Insureds: Garney Holding Company Garney Companies, Inc. Grimm Construction Company, Inc. Garney Wyoming, Inc. Garney New Mexico, Inc. Garney Federal, Inc. Encore Construction Group, Inc. Garney Colorado, LLC Garney Water Partnership Garney P3, LLC Following Form Primary/Underlying Policies with Liberty Mutual Fire Insurance Company: General Liability including Completed Operations Policy #TB2-641-426942-727, Eff. 10-1-2017/10-1-2018 Automobile Liability Policy #AS2-641-426942-717, Eff. 10-1-2017/10-1-2018 Employers Liability/Workers' Compensation Policy #WA2-64D-426942-737, Eff. 10-1-2017/10-1-2018 Employers Liability/Workers' Compensation Policy #WC2-641-437723-907 — WI only, Eff. 10-1-2017/10-1-2018 Following Form Coverage A - Excess Liability includes Blanket Additional Insured, Primary and Non -Contributory and Blanket Waiver of Subrogation as required by written contract. Includes All Work and Operations Performed by insured covered by Primary/Underlying policies. For the following additional Named Insureds: Garney Pacific, Inc. Garney Hawaii, Inc, Following Form Primary/Underlying Policies with Liberty Mutual Fire Insurance Company: General Liability including Completed Operations Policy #TB2-641-444498-027, Eff. 10-1-2017/10-1-2018 Automobile Liability Policy #AS2-641-44498-017, Eff. 10-1-2017/10-1-2018 Employers Liability/Workers' Compensation Policy #WA2-64D-444498-037, Eff. 10-1-2017110-1-2018 Following Form Coverage A - Excess Liability includes Blanket Additional Insured, Primary and Non -Contributory and Blanket Waiver of Subrogation as required by written contract. Includes All Work and Operations Performed by insured covered by Primary/Underlying policies. ACORD 101 (2008/01) © 2008 ACORD CORPUKA I IUN. All rights reserve(]. The ACORD name and logo are registered marks of ACORD