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Home My WebLink About166269 GARNEY CO - INSURANCE CERTIFICATE (21)ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(ItMADVYI� 1 9/28/2017 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(iss) must have ADDITIONAL INSURED provisions or be eMorsed. 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 816-395-8558 (AC,NI, 816-467-5558 (�) MESS: carolyn_short@ajg.com INSURERM AFFORDING COVERAGE NAICI INSURER A:TravelerS Property Casualty Co of America 25674 INSURED GARNCOM-01 Garney Holding Company (See attached fist of Additional Named Insureds) 1333 NW Vivion Road Kansas City MO 64118 INSURER B: INSURERC: INSURERD: _ INSURER E : INSURER F : rrI I •r, runrn- 1 ZR4(1174R REVISION NUMBER, I..VVtKHbtJ �.crcrrr wr�r� �wmo�rc. ,�� •� .- .-------�- 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 E TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDDlYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAMAGE E CLAIMS -MADE 17 OCCUR TO RENT PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ PRO- LOC ❑ PRO- POLICYJECT $ OTHER: AUTOMOBILE LIABILITY Ea accident $ BODILY INJURY (Per person) $ ANY AUTO BODILYINJURY(Peraccident) $ — OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON-OWNEDTY AUTOS ONLY AUTOS ONLY Per accident $ $ A X UMBRELLA LIAB X OCCUR ZUP-14S78452-17-NF 10/1/2017 10/1/2018 EACH OCCURRENCE $15,000,000 AGGREGATE $15,000,000 EXCESS LIAB CLAIMS -MADE DIEDX RETENTION $None WORKERS COMPENSATION ISTATUTE ERH $ E.L. EACH ACCIDENT E AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYE $ OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) NIA E.L. DISEASE -POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Renmrks Schedule, may be attached if more space Is required) See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins, Colorado THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 4316 LaPorte Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins CO 80525 AUTHORIZED REPRESENTATIVE A— C 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 +1: — -- -- AC"R" ADDITIONAL REMARKS SCHEDULE Rage - �— of -1 AGENCY Arthur J. Gallagher Risk Management Services, Inc. NAMED INSURED Garney Holding Compan (See attached list of Additional Named Insureds) 1333 NW Vivion Road POLICY NUMBER Kansas City MO 64118 CARRIER NAIC CODE EFFECTIVE DATE: AnnITWIPJAi DFRAADI(C 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. 10-1-2017110-1-2018 Employers Liability/Workers' Compensation Policy #WA2-64D-444498-037, 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. ACORD 101 (2008/01) V LUUt$ AL UKU I.UKt'VKH I wrv. MII nyrna Fe7>a1vcU. The ACORD name and logo are registered marks of ACORD