HomeMy WebLinkAboutWANER CONSTRUCTION COMPANY INC - INSURANCE CERTIFICATE (6)7 ® DATE (MMIODNYYY)
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CERTIFICATE OF LIABILITY INSURANCE 02/2e/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 be endorsed. If SUBROGATION IS WAIVED, subject to
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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 1-303-534-4567 CONTACT
NAME:
INA, Inc. - Colorado Division PHONE IFAX
(A/C, No. Lo, _ AIC Nol__
E-MAIL donaccounttechBQImacorp.Com
1705 17th Street ADDRESS:
Suite 100 INSURE S AFFORDING COVERAGE NAIC8
Denver, CO 80202 INSURERA: VALLEY FORGE INS CO (CNA) 20508
INSURED INSURERS: NATIONAL FIRE INS CO OF BARTFORD(CNA) 20478
Waner Construction Company, Inc. INSURERC: CONTINENTAL nN CO (CHA) 35289
8950 Barron Blvd, Unit 103 INSURERD: PINNACOL ASSUR 41190
INSURER E : TRAVELS PROP CAS CO OF Alai 125674
Highlands Ranch, CO 80129 INSURERF:
CAVFRAr.FC CFRTIFICATF NIIMRFR- 49230058 REVISION NUMBER:
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 TG 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.
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INSR ADDL SUBR POLICY EFF POLICY EXP LlYrrf
LTR ME OF INSURANCE POLICY NUMBER MYID MMIDD
A
x
COMMERCIAL GENERAL LIABILITY
2092449581
03/01/17
03/01/18
EACH OCCURRENCE
s 1,000,000
CLAIMS -MADE Lx ] OCCUR
D AMAGE TO RENTED
PREMISES Ea occurrence
1 300,000
x
MED EXP (Any one person)
f 15,000
PD Dad: $2, 000
PERSONAL 6 ADV INJURY
= 1,000,000
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
= 2,000,000
GEML
PRODUCTS -COMPJOPAGG
= 2,000,000
POLICY FX1 JECT lJ LOC
S
OTHER.
B
AUTOMOBILE LIABILITY
2092449595
03/01/17
03/01/16
COMBINED SINGLE LIMIT
Es swident
t 1,000,000
BODILY INJURY (Per person)
$
x ANY AUTO
BODILY INJURY (Per accident)
S
ALL OWNED SCHEDULED
AUTOS - TN -OWNED NO
x HIRED AUTOS x AUTOS
PROPERTY DAMAGE
Per accdent
i
C
x
UMBRELLA LIAB
x
OCCUR
2092449578
03/01/17
03/01/18
EACH OCCURRENCE
$ 2,000,000
AGGREGATE
$ 2,000,000
EXCESS LIAR
CLAIMS -MADE
DED I x I RETENTIONS 10, 000
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNERIEXECUTIVE —
OFFICER/MEMBER EXCLUDED9
(Mandatory In NH)
N 1 A
4107186
03/01/17
03/01/18
PERD
x 'TA LITE OR
E.L. EACH ACCIDENT
-'
$ 500, 000
El. DISEASE - EA EMPLOYE
f 500,000
E L. DISEASE - POLICY LIMIT
1 500,000
If yes, descnbe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If man spa" Is mqulmd)
Certificate Holder is included as Additional Insured on the General Liability Policy if required by written contract or
agreement and with respect to work performed by Inured subject to the policy terms and conditions.
CFRTIFICATF HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 580 AUTHORIZED REPRESENTATIVE / /^��
Fort Collins, CO 80522-0000 / /
USA [[[
1933-2014 ACORU COHPONAI ION. All rights reservea.
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
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SUPPLEMENT TO CERTIFICATE OF INSURANCE
DATE
02/28/2017
NAME OF INSURED: Waner Construction Company, Inc.
Additional Description of Operations/Remarks from Page 1:
Additional Information:
Builders Risk Coverage:
Policy #QT6608F328010TIL17 Effective Dates: 03/01/2017-03/01/2018 Insurer E: See Above
New or Non -Structural Renovation Projects:
$5,000,000 Frame Limit; $10,000,00U Joisted Masonry Limit; $25,000,000 Non -Combustible Limit;
$25,000,000 Masonry Non -Combustible, Modified Fire Resistive, or Fire Resistive;
$500,000 Temporary Storage/Property in Transit Limit; $5,000 Deductible; SPC Form/RC
$5,000,000 Flood/Earthquake Sub Limit; $25,000 Deductible
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