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HomeMy WebLinkAbout365691 BRYAN CONSTRUCTION INC - INSURANCE CERTIFICATE (18)ACORD, CERTIFICATE OF LIABILITY INSURANCE F DATE(MM/DDrYWY) 2/1/2018 1 4/27/2017 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 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 endorsement(s). PRODUCER Lockton Companies 8110 E. Union Avenue Suite 700 Denver CO 80237 CONT CT NAME: PHONE A/C, No Ext : A/C No): E-MAIL ADORES : INSURER AFFORDING COVERAGE NAIC # (303) 414-6000 INSURER A: Liberty Mutual Fire Insurance Company 23035 INSURED Bryan Construction, Inc. INSURER B : Everest National Insurance Company 10120 1410792 7025 Campus Drive Colorado Springs, CO 80920-3164 INSURER C : Pinnacol Assurance Com anv 41 190 INSURER D: Berkley National Insurance Company 3891 1 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 14021439 REVISION NUMBER: XXXXXXX 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/D /YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR Y N TB2-Z91467265-037 4/30/2017 4/30/2018 EACH OCCURRENCE 1,000,000 DAMAGE SES� a oNeur ante 300,000 MED EXP (Any oneperson) 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY❑ JECOT- ❑ LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000 000 $ A AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY AUTOSULED HIRAUTOS ONLY X AUTOS ONLY N N AS2-Z91-467265-027 4/30/2017 4/30/2018 COMBINED SINGLE LIMIT Ea accident $ 1 00,000 BODILY INJURY (Per person) $ XXXXXXX Ix BODILY INJURY (Per accident $ XXXXXXX Peer acciden DAMAGE $ XXXXXXX $XXXXXXX B D UMBRELLA LIAB EXCESS LIAR NCLAIMS-MADE OCCUR N N XC5EX00181-171 CEX0960267600 4/30/2017 4/30/2017 4/30/2018 4/30/2018 EACH OCCURRENCE $ 25,000000 X AGGREGATE $ 25,000,000 DED RETENTION $ $ XXXXXXX C WORKERS COMPENSATIN AND EMPLOYERS' LIABILITY Y/N AN PROPRIETOR/ OFFICER/MEMBER EXCLUDED? ARTNER/EXECUTIVEFN (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A N 2310880 2/1/2017 2/1/2018 X I STATH- TUTE OER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The certificate holder is listed as additional insured in regards to the 7136 Lincoln Center Addition and Renovations project. CERTIFICATE HOLDER CANCELLATION See Attachments 14021439 City of Fort Collins 300 Laporte Avenue Fort Collins CO 80522 ACORD 25 (2016/031 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 a'l ir% � l�, ©1 8 2015 ACORD CORPOFIITION. All rights reserved The ACORD name and logo are registered marks of ACORD