HomeMy WebLinkAbout365691 BRYAN CONSTRUCTION INC - INSURANCE CERTIFICATE (16)ACORD. CERTIFICATE OF LIABILITY INSURANCE 4/30/2017
DATE(MM/DD/(YYY)
1 /30/2017
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 endorsement(s).
PRODUCER Lockton Companies
8110 E. Union Avenue
Suite 700
Denver CO 80237
(303) 414-6000
CONTACT
NAME:
PHONI!'- FAX
A/C No Ext : A/C No):
E-MAIL
ADDRESS:
INSURER AFFORDING COVERAGE
NAIC #
INSURER A: The Continental Insurance Company
35289
INSURED Bryan Construction, Inc.
1410792 7025 Campus Drive
Colorado Springs, CO 80920-3164
INSURER S : Transportation Insurance Company
20494
INSURER C : Pinnacol Assurance Companv
41 190
INSURER D : Endurance American Insurance Company
10641
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 14021439 REVISION NUMBER: XXXXXXX
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
ADDL
INSD
SUBR
WVD
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE 1 OCCUR
Y
N
6016501140
4/30/2016
4/30/2017
EACH OCCURRENCE
1,000,000
DAMAGE TO RENTED
PREMISES Ea occurrence
500,000
MED EXP (Any oneperson)
15,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY❑ PRO ❑ JECT LOC
OTHER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
B
AUTOMOBILE LIABILITY
O
SCHEDULED
NLY AUTOS
NLY X NON-OWNED
ONLY
I
N
N
6016501137
4/30/2016
4/30/2017
Ea acccldentSUJGLE LIMIT
$ 1,000 OOO
BODILY INJURY (Per person)
$ �{XXXxxx
BODILY INJURY (Per accident
$ X}{X'Xxxx
PerOa cldenDAMAGE
$XXXXXXX
$XXXXXXX
A
DLIAB
LA LIAR
X
OCCUR
CLAIMS -MADE
N
N
6024358179
EXC30000127600
4/30/2016
6/20/2016
4/30/2017
4/30/2017
EACH OCCURRENCE
$ 25 000 000
AGGREGATE
$ 25 000.000
RETENTION $
$XXXXXXX
�-
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED N❑
(Mandatory in NH)
DESCRIPTION OF OPERATIONS below
N / A
N
2310880
2/1/2017
2/1/2018
X STATUTE ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
1,000,000
E.L. DISEASE - POLICY LIMIT
S 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
The certificate holder is listed as additional insured in regards to the 7136 Lincoln Center Addition and Renovations project.
CERTIFICATE HOLDER L ANtr_LLA I IUN Jee ALtaCflrrICIILS
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
14021439 AUTHORIZED REPRESENTATIVE
0of Fort Collins
Laporte Avenue
Fort Collins CO 80522
J C !
err)pn ?F rgniAinst 198812015 ACORD CORPOKJkTION. All rights reserved
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