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HomeMy WebLinkAboutBARTRAN CONSTRUCTION INC - INSURANCE CERTIFICATE (4)OP ID: CT ACORD DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 01/11/2018 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). CONTACT PRODUCER Phone: 970-223-1804 NAME, Front Range Insurance Group PHONE FAX 2002 Caribou Drive, Ste. 101 Fax: (A/c. No. Ext): (A/C. No): Fort Collins, CO 80525 E-MAIL Steven G. Smith ADDRESS: PRODUCER rttcTnUPR mr. BARTR-2 INSURED Bartran Construction, Inc. Dan Bartran P.O. Box 270855 Ft. Collins, CO 80527-0855 INSURERS) AFFORDING COVERAGE NAIC # INSURER A: Builders Insurance Group 10704 INSURER B : Pinnacol Assurance 41190 INSURER C: Secura Insurance Companies 22543 INSURERD:Zurich North America F: rnvcvAMl=Q rt=aTlLlr ATF NIIMRFR• RFVISInN NIIMRFR- 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. ILTR LTR TYPE OF INSURANCE DDL UB POLICY NUMBER MOL ICY EFF POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X GLP0116858 12/27/2017 12/27/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 �G'EWL AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ C C C AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X A3145376 A3145376 A3145376 12/27/2017 12/27/2017 12/27/2017 12/27/2018 12/27/2018 12/27/2018 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ $ A UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE X UM60117090 12127/2017 12/27/2018 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 - DEDUCTIBLE RETENTION S 10,000 $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below IN / A 4136220 02/01/2017 02/01/2018 X I WC STATU- OTH. RY LIMITS R E.L. EACH ACCIDENT $ 500,00 E.L. DISEASE - EA EMPLOYEE $ 500,00 E.L. DISEASE - POLICY LIMIT I $ 500,000 C D �Eqiup Fltr CP3145375 12/27/2017 Builders Risk 'BR68317728 01/16/2017 12/27/2018 01116/2018 �Lsd & Rnt 25,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule. if more space is required) City of Fort Collins is named as additional insured as required by written contract. GERIIFIGAI It HULUtK trAr4L rI_LA I IUIV FTCOL-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. 970-224-6134 P.O. Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522-0580�C< © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD