HomeMy WebLinkAboutNORTHSTAR CONCRETE INC - INSURANCE CERTIFICATE 2023-2024A��R�� CERTiFICATE OF LIABILITY INSURANCE onre�MMroamm�
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THIS CERTIFICATE fS ISSUED AS A MA7TER OF IkFORMATION ONLY AN� CQNFERS NO RIGHTS UPON TWE CERTIFICATE kOLDER. TH15
CERTIFICATE �OES �IOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR AL7ER THE COVERAGE AFFORDED BY THE POLiCIES
BELOW. TH1S CERTIFICATE OF INSURAMCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(Sj, AUTHORIZED
REPRESENTATIVE OF2 PRODUCER, AND 7HE CER71FlCATE HOL�ER.
IMPDRTANT: If the certificate holder Is an ADDITiONAL INSURED, the policy(Ees) must have ADDITIONAL INSUR�� provisions or be andprsed.
If SUBROGATiON IS WAlVED, subject to the terms and conditions of the policy, certain policiea may require an endorsement A statement on
this certificate dces not confer rtghts to the certificate holder in Ileu of such endorsertsent(s}.
VROOUCEA NAMEA Jennifer Winter, CISR
Flood and Peterson PIiONE (g70} 506-3206 A 970} 5U6-6846
A!C No Ext : NC No :(
PO Box 578 E;,µ o�«�. JWinter[�floodpeterson.com
Greeley
INSURED
Norlhstar Concrele, Inc.
1220 S. GarfieldAvenue
Loveland
COVERAGES
CO 8D632
CO 80537
CERTIFICATE NUMBER: CL23
iNSUR@R A :
INSl1RER B :
iNsuaeR c :
iNsuaeR o :
3NSURER E :
AFFOROING COVERAGE
REVISION NUMBER:
NAIG Y
31325
41190
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN iSSUED TO �HE INSUREO NAMED ABOVE FOR THE POLICY PERIO�
INDICATEb. NOilMTHSTANDING ANY R�QUIREMENT, TERM OR CONpITION OF ANY CONTRAGT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFIGATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORQED BY THE ?OLICIES �ESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCIUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HRVE BEEN REDUCED 8Y PAID CLAIMS.
�L7'� 7YPE OF INSURANCE �Ngp yyyp P�LICY NUMBER MMlOOIYYYY MMlODIYYYY LIMIFS
X COMMERCIAL GENERAL LIABILI7Y £ACH OCCURRENCE S ��000,000
CLA1M5-MAOE ❑X OCCUR PREMISES EapC[urrenC.e s 5DO,ODO
X BI1PD Ded;O Meo �xP �Am o�e o��w�i s 15.00D
A Y CPA3294436-21 07I0112023 07lQ1I2024 pER$QNpL$A�V{NJURY 5�.D00,000
GHN'LAGGREGATEUMITAPPLIESPER GENERALAGGREGATfl 5 z,d00.000
POLICY ❑X pR� � 2,a0QUQ0
JECT LOC PRODUCTS-COMP70PAGG S
OTtiER S
AUTOMOBILE LIABILITY COIN8INED $INGIE LIMIT g j,QOU,000
Ea accldenl
x ANY AUTO BQDILY IN,7URY (Per persani 5
a OWNEO SCHE�ULEU Y CPA 3294436-21 07I0112023 07101/2024 BODILY INJURY �Per acatlenq 5
AUTOS ONLY Al1T0S
NiRE� NON•OWNEO PROPERTY OAMAG� 5
%� AUTO5 ONLY x AUTOS ONLY Per attidenl
x DOC s
x UMBRELLA LIAB x p�CUR EACH OCCURRENCE g 1.006,000
A ElCCE55 LIAB ��ptM5-MApE CPA 3294436-21 0110112023 07101/2024 nGGREGATE S 1.000,000
�ED %C RETEN710N S � S
WDRKERS COMPENSATIDN x PER DiH�
AND EMPLOVERS' iIABILI7Y S7A7UTE ER
Y 1 N 1.00D.000
B ANY PROPRIE7ORlPARTNERIERECUTIVE � N IA 4'IOBOBO O%IO'IIZOZ.3 O�JQ'IIZOZ4 E �' �CHACCI4ENT $
OFFICER�MEMBER fJCCLUDED�
(MintlitOYy in NH} E L bl$EASE - EA EMPLOYEE $���Q�.��a
II yes, descnbe under 1.000. D00
DESCRIPTIOh OF OPERATIONS below E L DISEASE - POLiCY LIi11T S
DESCRIPTION OF OP£RATIONS 1 LOCATIONS f VEHICLES {ACORD 101, Additional Remarka Sehedule, may be attached iT more space is requiredj
Cfty of Fort Collins is listed as an Addttional Insured as respects General Liability, including ongoing and completed aperatlons, and Auto Llabdity.
City of Farl CoAins
PO Box 580
SH011iD ANY OF THE ABOVE DE5CRIBED POLICIES 8E CANGELLE� BEFORE
THE EXPIRATION DATE THEREOF, NOTICE 41fILL 8E DELIVERED IN
ACCORDANCE WITH 7HE POLICY PROViSIONS.
AUTMORIZED REPRESENTATIVE
Fort Collins
ACORD 25 [2016l03)
CO 80522 � �
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