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Home My WebLink About166269 GARNEY CO - INSURANCE CERTIFICATE (23)® ACORO CERTIFICATE OF LIABILITY INSURANCE DATE'�{/DDIYYWl 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 ORALTER, THIE COVERAGE AFFORDED 'BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INISURER(S), At4THORIZED 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 CONTACT NAME: CafOlyfl hort S_ Arthur J. Gallagher Risk Management Services, Inc. PHONE 816-395-8558 FAX 816-467-5558 2345 Grand Blvd., Suite 400 cAIL — (Aic`"°) Kansas City MO 64108 E-MIL-carolyn_short@ajg.com 7 INSURER(S) AFFORDING COVERAGE NAIL i INSURER A:Travelers Proper!Proper!y Casualty Co of America 25674 INSURED GARNCOM-01 INSURER B : Garney Holding Company INSURERC: (See attached list of Additional Named Insureds) INSURER D: 1333 NW Vivion Road Kansas City MO 64118 INSURER E: INSURER F : .-. � Gr1779 G9 �Ct oC\/I CIn111 11111�1IQCD• THISISTO 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 'ADD TYPE OF INSURANCE INSDL SWVD I - - - POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDDlYYYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS-MADE^�', OCCUR EACH OCCURRENCE $ PREMISES Ea orc urrence $ MED EXP (Anyone person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: PRO- J LOC POLICY ❑ JECT OTHER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY I Ea accident $ BODILY INJURY (Per person) E BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident) $ $ A X UMBRELLA LIAB X OCCUR EXCESS LIAB CLAIMS -MADE DIED X RETENTION $ None Y Y ZUP-14S78452-17-NF 10/1/2017 10/l/2018 EACH OCCURRENCE $15,000,000 AGGREGATE $15,000,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YN/A OFFICERIMEMBER EXCLUDED9 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below OTW STIN ATUTE ER E.L. EACH ACCIDENT $ - $ _ E.L. DISEASE - EA EMPLOYE E.L. DISEASE - POLICY LIMIT $ i DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) See Attached... r CDTIc Ir ATG 41n1 1117D GANGELLAI IUN 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 80522 AfTHUTHORIZED REPRESENTATIVE V U 1U88-ZU15 AGUKU L;UKYUKAI IUN. All ngn[s reserves. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGEW Y CUSTOMER'ID; GW= a LOC III: ACOR" AnnITIONAI RFMARKS SCHFM It F '°woe 1 of 1 AGENCY NAMED INSURED Arthur J. Gallagher Risk Management Services, Inc. Garney Holding Company (See attached list of Additional Named Insureds) POLICY NUMBER 1333 NW Vivion Road Kansas City MO 64118 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS 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 (2008101) - zuuts AL UKU I.UKYUKHI IUIY. HII nyrR, ICDCI VGu. The ACORD name and logo are registered marks of ACORD