HomeMy WebLinkAbout992672.tiff ACORD_ CERTIFICATE OF LIABILITY INSURANC ID y 1 I DATE("M°D""
SH 10/21/99
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Business Insurance Agency,Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
353 Vets Memorial Hwy ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Commack NY 11725
Phone: 516-864-2200 Fax:516-864-2344 INSURERS AFFORDING COVERAGE.
INSURED INSURER A: CGU Insurance Companies
INSURER B: Fireman's Fund Insurance Co.
Walsh Construction Inc INSURER C: Travelers Property Casualty______
5828 No. St. Louis Ave INSURER D:
Loveland CO 80538 -- - -
INSURER E:
COVERAGES
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
POUCIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE POLICY NUMBER DATE(MMIDDM') DATE(MM/DDNY)N
LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY CPP1178170 02/22/99 02/22/00 FIRE DAMAGE(Any one fire) 550,000 __
1 CLAIMS MADE X OCCUR MED EXP(Any one person) S 5,000
PERSONALBADV INJURY f 1,000,000
GENERAL AGGREGATE S 2,000,000
GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIDP AGG $ 1,000,000
7 POLICY JE& ILO AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
$
ANY AUTO (Ea accident)
ALL OWNED AUTOS BODILY INJURY
f
SCHEDULED AUTOS (Per Person)
HIRED AUTOS BODILY INJURY
NON-OWNED AUTOS (Per accident) S
PROPERTY DAMAGE $
-'" (Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S
ANY AUTO EA ACC f
OTHER THAN
AUTO ONLY. AGG f
EXCESS LIABILITY EACH OCCURRENCE 51,000,000
B X IOCCUR [] CLAIMS MADE XYZ00083857680 06/09/99 02/22/00 AGGREGATE 51,000,000_ _
DEDUCTIBLE $
X RETENTION S 10,000
WC STAIU-
WORKERS COMPENSATION AND TORY LIMITS1_ ER
EMPLOYERS'LIABILITY
A wC0343615 02/22/99 02/22/00 E.L.EACH ACCIDENT $ 500,000__
E.L.DISEASE-EA EMPLOYEE S 500,000
E.L.DISEASE-POLICY LIMIT $ 500,000
OTHER
C Installat. Floater QT660524X7845 04/20/99 04/20/00 All Risk $50,000 ea
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/IXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
As respects Contract for Rehabilitation of Bridges following are included as
additional insureds: Weld County, Colorado, by and trhough the Board of
County Commissioners of Weld County, its employees and agents
CERTIFICATE HOLDER Y ADDI)IONAL INSURED;INSURER LETTER: CANCELLATION
WELDCOU SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRRTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF
Weld County Public Works
1111 H. Street ANY KIND UPON THE INSURER.RS AGENTS OR REPRESENTATIVES.
Greeley CO 80631
ACORD 25-S(7/97) -----
(0— ndi I I - I - L34 992672
KSCONST
ACORDTM CERTIFICATE OF INSURANCE DATE(MM/DD TYE
70/25 /9 /
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
HRH of Denver - ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
455 Sherman Street, Suite 390 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 9364 COMPANIES AFFORDING COVERAGE
Denver, CO 80209
LT COMPANY
ACrum & Forster Insurance - U. S . Fire
INSURED COMPANY
KS Construction Services, Inc_, BCalifornia Indemnity Insurance
4690 Ironton Street
COMPANY
Denver, CO 80239
c
COMPANY
D
COVERAGES ---- ------.
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 -IRIS
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.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE(MM/DD/YY) DATE(MM/DD/YY)
A GENERALUABILITY 5031793179 �. 07/01 /99 07/01/00 GENERAL AGGREGATE C , 000 , 0( G
X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGC sO , 0 0 0 , 0 C Q
CLAIMS MADE X I OCCUR PERSONAE 8 ADV INJURY Si , 000 , 0( C'
OWNER'S S CONTRACTOR'S PROT EACH OCCURRE.NCI $). , 0 0 0 , 0 C C1
FIRE DAMAGE.Any one Ire' $ 300 , CC C
MED LXP'Any ene sersen) $ 15 , 0 C C_ _
A AUTOMOBILE LIABILITY 1336495122 07/01/99 07/01/00
COMBINED SINGLE I IMIT $C. , 000 , 00 C
X ANY AUTO
ALL OWNED AU FOS
BODILY INJURY $
SCHEDULED AUTOS (Per person
X HIRED AUTOS
BODILY INJURY $
X NON-OWNED AUTOS (Per accident)
PROPERTY DAMACI $
GARAGE LIABILITY AUTO ONLY EAACCIDENT $
ANY AUTO OTHER THAN Al ITC ONLY.
I ACH ACCIDENT $
AGGREGATE $
A EXCESS LIABILITY 5530645719 07/01/99 07/01/00 'EACH OCCURRINCI $2 , 000 , 100
X UMBRELLA FORM AGGREGAFE $2 , 000 , CC)0
OTHER THAN UMBRELLA FORM $
B WORKERS COMPENSATION AND ' E1059577A 07/01/99 07/01/00 X L I I GORY LIMITS
EMPLOYERS'LIABILITY
EACH ACC'JDEN I s 10 , 1
THE PROPRIETOR/ INCL DISEASE-POLICY L MIT $ 500 , 1 1 )
PARTNERS/EXECUTIVE
OFFICERS ARE EXCL DISEASE-LACE EIMPLOYFE $ 1 C/0 , C J C)
OTHER
DESCRIPTION OF OPERATIONS/LOCAT1ONSNEHICLES/SPECIAL ITEMS
Centennial Center, 915 10th Street and Marlborough Building, 934 9th Ave .
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Weld County, Colorado EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
915 10th Street 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT
Greeley, CO 80634 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REP N ♦TII,vE AM1.jorACORD 25-S211 n�3)�1,�nf 1 #S82615./M78718 7, __FF.. �O AuORD CORPORATION 1993
c_Dnse t o 1`do p- - '�9
Hello