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Home My WebLink About166269 GARNEY CO - INSURANCE CERTIFICATE (24)ACORO CERTIFICATE OF LIABILITY INSURANCE:- I DATEOWDDIYYYY) 1 912812017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RJC#ITS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTEU,THE COVERAGE AFFORDED BY THE P )) I'AES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTncikILED 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 endcnrsed.' If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A sUdonertt on this certificate does not confer rights to the certificate holder in lieu of such endorsements . CONTACT PRODUCER NAME: Carolyn Short Arthur J. Gallagher Risk Management Services, Inc. PHChE _,. 816-395-8558 (FAX No), 816-467-5558 2345 Grand Blvd., Suite 400 EMA Kansas City MO 64108 IL . carolyn_short@ajg.com INSURER(S) AFFORDING COVERAGE NAIL I_ INSURER A: Travelers Property Casualty Co of America 25674 - INSURED GARNCOM-01 INSURERS:----- Garney Holding Company INSURERC: _ (See attached Ist of Additional Named Insureds) INSURERD: 1333 NW Vivion Road Kansas City MO 64118 INSURERE: _ INSURER F : --.•___--- �..�.�. .��........�.. 1-7cne2rc1() orvlcnnAnwulaecco. 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' TYPE OF INSURANCE LTR I WVD ... POLICY NUMBER POLICY EFF MM/DDNYYY POLICY EXP MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR EACH OCCURRENCE E PREMISES Ea occurrence f MED EXP (Anyone person) E PERSONAL & ADV INJURY E GEN'L AGGREGATE LIMIT APPLIES PER: POLICY u PROECT ❑ LOC J OTHER: GENERAL AGGREGATE $ PRODUCTS - COMP/OPAGG E $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIM[ I Ea accident) S BODILY INJURY (Per person) E BODILY INJURY (Per accident) f DAMAGE— Per accident E A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE Y Y IZUP-14S78452-17-NF 10/1/2017 10/1/2018 EACH OCCURRENCE $15,000,000 AGGREGATE $15,000,000 DEO X 1 RETENTIONS None f WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE a OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If es, describe under DESCRIPTION OF OPERATIONS below NIA STATUTE ERH E.L. EACH ACCIDENT E E.L. DISEASE - EA EMPLOYE E E.L. DISEASE - POLICY LIMIT E DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) See Attached... rrn-rirrrArr- unn nro rANrFI I ATInN City of Fort Collins, Colorado 4316 LaPorte Avenue 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. AUTHORIZED REPRESENTATIVE ek) - a V IVt5?5-LV Ib AUUKU I..VMrUKAMI IVIV- ran 1191ILJ 1 vca.,. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD ' t ? -vkGENcy cumwk iD: GARNC1. _M"_' LOC ACO ADDITIONAL RFMARKS SCHEDULE AGENCY Arthur J. Gallagher Risk Management Services, Inc. POLICY NUMBER CARRIER UIVAL KtMAKKJ NAIC CODE NAMED INSURED Garney Holding Company (See attached list of Additional Named Insureds) 1333 NW Vivion Road Kansas City MO 64118 EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORMTITLE: 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. Garvey Federal, Inc. Encore Construction Group, Inc. Garvey Colorado, LLC Garvey Water Partnership Garvey P3, LLC page 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: Garvey 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. 10-1-2017/10-1-2018 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. Project or Job #: Garney Job #6247 Project: Boxelder Creek Outfall Work Order 1 B - ELCO Waterline Relocation ACORD 101 (2008/01) cVV0 M.vrcv The ACORD name and logo are registered marks of ACORD