HomeMy WebLinkAbout250056 WYATT CONSTRUCTION CO INC - INSURANCE CERTIFICATE (6)GATE (MWDDfrM)
AC")?" CERTIFICATE OF LIABILITY INSURANCE
L 1 4/18/2017
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
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 CONTACT Care Bueno,
NAME: y
Taggart and Associates, Inc PHONE (303) 442-1484 _ FAX (303)442-8822
LA/C, No,_ExtL
1600 Canyon Boulevard ADDRIL cbueno@taggartinsurance.com
P . 0. Box 147 INSURERS AFFORDING COVERAGE NAIC If
Boulder CO 80306 INSURERA:The Cincinnati Insurance Company 10677_
INSURED INSURERB:Trayelers Prop Cas Ins Co 36161
- --------------+-----
Wyatt Construction Co. Inc. INSURERC:
3223 Arapahoe Ave. Suite 100 INSURERD:
Boulder CO 80303 I INSURER F :
r+n%100Ar--1=c f`r-0TILIrATG rJIIMRFR•17/18 Master REVISION NUMBER'
TH:S 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.
ILTR - - - ADDL $UBR POLICY EFF POLICY EXP LIMITS
TYPE OF INSURANCE POLICY NUMBER MM/DO YYYY MM/DD/YYYY
X COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE $ 1,000,000
I
-DAMAGE TO RENTED j
PREMISES�occurrenoe $ 500,000
A CLAIMS -MADE X OCCUR
..!
EPP0138088 5/1/2017
5/1/2018
MED EXP (Any one person) $ 10,000
PERSONAL & ADV INJURY $ 1,000,000
GE'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE $ 2,000 , 000
Pot ICY R� JE 0 r� LOC
PRODUCTS -COMP/OP AGG $ 2,000,000
$
OTHER
AUTOMOBILE LIABILITY
-COMBINED
SINGLE LIMIT $ 1,000,000
accident)
I_JEa
A
X ANY AUTO
BODILY INJURY (Per person) $
ALL OWNED SCHEDULED
AUTOS
EPP0138088 5/1/2017
5/1/2018
BODILY INJURY (Per accident) $
AUTOS
NON -OWNED
YtDAMAGE $
PROPERTY
- HIRED AUTOS AUTOS
__-
$
X
UMBRELLA LIAR
I X
OCCUR
EACH OCCURRENCE Is 10, 000, 000
B
EXCESS LIAB_
CLAIMS MADE
AGGREGATE - $ 10 000 000
_
x
DED RETENTION $ 10 000
ZUP15T3750817NF 5/1/2017 5/1/2018
$------L____r._._.-
WORKERS COMPENSATION
STATUTE I I ER_
AND EMPLOYERS' LIABILITY YIN
ZANY
PROPRIETOR/PARTNER/EXECUTIVE
E.L.EACHACCIDENT $ -
OFFICER/MEMBER EXCLUDED? ❑
N/A
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE $
If yyes, describe under
DESCRIPTION OF UPERA i IONS below
E.L. DISEASE - POLICV LIMIT $
I
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
GERAIFIGAIE HULUEK VF11Yl CLLMIIVIY
City of Fort Collins
PO Box 580
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
Carey Bueno/CMB
U 119S8-2U14 AGUKU GUKI'UKA I IUN. All rlgnLs reserve0.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
INS025 (201401)