HomeMy WebLinkAbout962291.tiff A C'1111/e CERTIFICATE OF INSURANCE DAS 02596 ISSUE DATE (MM/DDNY)
n 12/02/96
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE
DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
THE LINDEN COMPANY POLICIES BELOW.
2000 SO. COLORADO BLVD COMPANIES AFFORDING COVERAGE
DENVER CO 80222-7911
COMPANY AST. PAUL INSURANCE
LETTER
COMPANY B CIGNA INSURANCE COMPANY
INSURED LETTER
ROCHE CONSTRUCTORS, INC COMPANY C
P.O. BOX 1727 LETTER
GREELEY, CO 80632 COMPANY D
LETTER
COMPANY -E
LtlitR
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 THIS
EXCLUSIONS MAY CONDITIONS OF SUCH PERTAIN THE'
LIMITS SHOWNFMAY HAVE BEEN POLICIES DESCRIBED
Y PAID CL.AIMSEIN IS SUBJECT TO ALL THE TERMS.
POLICY EFFECTIVE POLICY EXPIRATION
TYPE OF INSURANCE POLICY NUMBER LIMITS
_TR DATE (MM/DD/YY) DATE (MM/DD/YY)
GENERAL LIABILITY KK08300368 12/01/96 12/01/97 GENERAL AGGREGATE $ 2, 000,000
kOMMERCIAL GENERAL LIABIUTY PRODUCTS—COMP/OPAGG. $ 2 ,000 ,000
�LAIMS MADE X OCCUR. PERSONAL&ADV.INJURY $ 1, 0 0 0, 0 0 0
OWNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE $ 1, 000,000
X PER PROJECT FIRE DAMAGE(Any one fire) $ 100,000
AGGREGATE MED.EXP.(Any one person) $ 5 , 000
ri AUTOMOBILE LIABILITY KK08300368 12/01/96 12/01/97 COMBINED SINGLE
X ANY AUTO LIMIT $ 1, 000,000
X ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per person) $
X HIRED AUTOS BODILY INJURY
X NON—OWNED AUTOS Par accidenq $
GARAGE LIABILITY
PROPERTY DAMAGE
$
7j EXCESSUABILITY KK08300368 12/01/96 12/01/97 EACHOCCURRENCE $ 5 , 000/ 000
UMBRELLA FORM AGGREGATE $ 5, 000,000
K. OTHER THAN UMBRELLA FORM
B C42251161 12/01/96 12/01/97 STATUTORYUMRS
WORKER'S COMPENSATION EACH ACCIDENT $ 500, 000
AND DISEASE—POUCY LIMIT $ 500,000
EMPLOYERS'LIABILITY S00 000
DISEASE—EACH EMPLOYEE $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
BOARD OF WELD COUNTY COMMISSIONERS (OWNER) , THE ENGINEER AND HIS
CONSULTANTS; AND EACH OF THEIR OFFICERS, AGENTS AND EMPLOYEES ARE HEREBY
NAMED AS ADDITIONAL INSURED AS RESPECTS TO WLED COUNTY NORTH JAIL COMPLEX
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO
BOARD OF WELD COUNTY MAIL_30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
COMM I S S I ONE RS LEFT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
915 10TH STREET LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES.
GREELEY CO 80631 AUTHORIZED RE ESE VE
ACORD,2$S t7190) QI 962291
/09A/6'
CERTIFICATE OF INSURANCE 'DAs 02596 ISSUE DATE (MM,.D/YY,
ac��ru® n 12/02/96
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE HOLDER.THIS
DOES NOT AMEND,EXTEND OR ALTERIFICATE THE COVERAGE AFFORDEDIFICATE BY THE
THE LINDEN COMPANY POLICIES BELOW.
2000 SO. COLORADO BLVD COMPANIES AFFORDING COVERAGE
DENVER CO 80222-7911 COMPANY A ST. PAUL INSURANCE
LETTER
COMPANY B COM PR
COM CIGNA INSURANCE COMPANY
INSURED LETT '-'
ROCHE CONSTRUCTORS, INC COMPANY C
P.O. BOX 1727 GI mR
SREELEY, CO 80632 COMPANY D
LETTER
COMPANY E
LEII'LR
COVERAGES
INDICATEDCNOTWITHSTANDING ANY REQUIR INSURANCE
TERM LISTED OF ANY CONTRACTOOR OTHER DOCUMENT WITH RESPECT POLICY
O WH CPERIOD
THIS
EXCLUSIONS MAY CONDITIONS OF SUCH PERTAIN,THE
INSURANCEIII N MAY HAVE BEEN POLICIES DESCRIBED P L.AIMSEIN IS SUBJECT TO ALL THE TERMS,
POLICY EFFECTIVE POLICY EXPIRATION UNITS
''O POLICY NUMBER
TYPE OF INSURANCE DATE (MM/OD/YY) DATE (MM/DDNY)
.TR
A GENERAL LIABILITY KK08300368 12/01/96 12/01/97 GENERAL AGGREGATE $ 2 ,000,000
X kOMMERCIAL GENERAL LIABILITY PRODUCTS—COMP/OP AGG. $ 2 , 000,000
�LAIMS MADE X OCCUR. PERSONAL&AOV.INJURY $ 1,0001000
OWNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE $ 1,000 ,000
X IPER PROJECT FIRE DAMAGE(Any one ere) $ 100,000
MEO.EXP.(Any one person) $ 5 ,000
AGGREGATE COMBINED SINGLE
A AUTOMOBILE LIABILITY KK08300368 12/01/96 12/01/97 $ 1,000, 000
UMIT X ALYAMO BODILY INJURY
X ALL OWNED AUTOS (Per person) $
SCHEDULED AUTOS BODILY INJURY
X HIRED AUTOS $
(Per eccideM
X NON—OWNED AUTOS
GARAGE UABIUTY PROPERTY DAMAGE $
EXCESS LIABILITY KK08300368 12/01/96 12/01/97 EACHOCCURRENCE $ 5,000 ,000
AGGREGATE $ 5/000,000
'd UMBRELLA FORM
OTHER THAN UMBRELLA FORM
C42251161 12/01/96 12/01/97 I sTATUTORYUMIrs
g WORKER'S COMPENSATION EACH ACCIDENT $ 500, 000
AND DISEASE—POLICY UMIT $ 500, 000
EMPLOYERS'LIABILITY DISEASE—EACH EMPLOYEE IS 500 ,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
PROJECT: WELD COUNTY NORTH JAIL COMPLEX. IT IS AGREED THAT THE CERT. HOLDER
kS OWNERS ARE NAMED AS AN ADDITIONAL INSURED ALONG WITH SUBCONTRACTORS, AS
THEIR INTERESTS MAY APPEAR. ADDED TO BLANKET POLICY EFF. 5/7/96
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO
BOARD OF WELD COUNTY MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
COMMI S S I ONE RS LEFT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
915 10TH STREET LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES.
AUTHOR! .ENTATIVE
GREELEY CO 80631
ION 1990
ACORD 254 t7/00)
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