No preview available
HomeMy WebLinkAboutVALMONT INDUSTRIES INC - INSURANCE CERTIFICATE 2023-2024Holder Identifier : 7777777707070700077761616045571110767717016204447207442027772507300072640577046230130737051113163000307173110273631103075772370631377650763511467406665607764415534076570076727242035772000777777707000707007 7777777707070700073525677115456000722000517026103107022226353063011070232362531720000702233624307310007033336353063110071323273531630000713232724217311107032227242063111077756163351765540777777707000707007Certificate No :570098160566CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 03/03/2023 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). 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. PRODUCER Aon Risk Services Central, Inc. Omaha NE Office 17807 Burke Street Suite 401 Omaha NE 68118 USA PHONE (A/C. No. Ext): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # (402) 697-1400 INSURED 22667ACE American Insurance CompanyINSURER A: 35378Evanston Insurance CompanyINSURER B: 10690Allied World National Assurance CompanyINSURER C: INSURER D: INSURER E: INSURER F: FAX (A/C. No.):(402) 697-1594 CONTACT NAME: Valmont Industries, Inc. 15000 Valmont Plaza Omaha NE 68154 USA COVERAGES CERTIFICATE NUMBER:570098160566 REVISION NUMBER: 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.Limits shown are as requested POLICY EXP (MM/DD/YYYY) POLICY EFF (MM/DD/YYYY) SUBR WVD INSR LTR ADDL INSD POLICY NUMBER TYPE OF INSURANCE LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR POLICY LOC EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG X X X GEN'L AGGREGATE LIMIT APPLIES PER: $2,000,000 $1,000,000 $10,000 $1,000,000 $4,000,000 $4,000,000 A 03/01/2023 03/01/2024 SIR applies per policy terms & conditions HDOG47350189 PRO- JECT OTHER: AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS HIRED AUTOS ONLY NON-OWNED AUTOS ONLY BODILY INJURY ( Per person) PROPERTY DAMAGE (Per accident) X BODILY INJURY (Per accident) $2,000,000A03/01/2023 03/01/2024 SIR applies per policy terms & conditions COMBINED SINGLE LIMIT (Ea accident) ISA H10758750 EXCESS LIAB X OCCUR CLAIMS-MADE AGGREGATE EACH OCCURRENCE DED $10,000,000 $10,000,000 $10,000 03/01/2023UMBRELLA LIABC 03/01/202403117418 RETENTIONX X E.L. DISEASE-EA EMPLOYEE E.L. DISEASE-POLICY LIMIT E.L. EACH ACCIDENT $1,000,000 X OTH- ER PER STATUTEA03/01/2023 03/01/2024 SIR applies per policy terms & conditions $1,000,000 Y / N (Mandatory in NH) ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED?N / AN WORKERS COMPENSATION AND EMPLOYERS' LIABILITY If yes, describe under DESCRIPTION OF OPERATIONS below $1,000,000 WLRC5202240A Each ClaimMKLV7PL000573603/01/2023 03/01/2024 Claims-Made Coverage $10,000,000Aggregate Deductible $500,000 Architects & Engineers Professional B SIR applies per policy terms & conditions $10,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is included as Additional Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. The General Liability and Automobile Liability evidenced herein is Primary and Non-Contributory to other insurance available to an Additional Insured, but only in accordance with the policy's provisions. A Waiver of Subrogation is granted in favor of Certificate Holder in accordance with the policy provisions of the General Liability, Automobile Liability, and Workers' Compensation policies. Umbrella policy follows form of underlying policies listed above. CANCELLATIONCERTIFICATE HOLDER AUTHORIZED REPRESENTATIVECity of Fort Collins Financial Services; Purchasing Division 215 N. Mason Street 2nd Floor Po Box 580 Fort Collinsq CO 80522 USA ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Schedule of Named Insureds AGENCY CUSTOMER ID: ADDITIONAL REMARKS SCHEDULE LOC #: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:ACORD 25 FORM TITLE:Certificate of Liability Insurance EFFECTIVE DATE: CARRIER NAIC CODE POLICY NUMBER NAMED INSUREDAGENCY See Certificate Number: See Certificate Number: Aon Risk Services Central, Inc. 10576471 570098160566 570098160566 Page _ of _ Valmont Industries, Inc. Valmont Industries, Inc. AgSense, LLC AgSense, LLC dba PrecisionKing AgSense, LLC dba PivoTrac Monitoring American Galvanizing Company, Inc. George Industries, Inc. Industrial Galvanizers America Holdings, Inc. Industrial Galvanizers America, Inc. Kendar Industries, Inc. DBA Irrigation Components International Torrent Engineering and Equipment Company LLC Valmont Telecommunications, Inc. (pka PiRod, Inc.) Valmont Telecommunications, Inc. dba Larson Camouflage Valmont Telecommunications, Inc. dba Valmont Site Pro 1 Valmont Telecommunications, Inc. United Galvanizing, Inc. Valley Export, Inc. Valmont - Birmingham Galvanizing, Inc. Valmont - Columbia Galvanizing, Inc. Valmont - Southeastern Galvanizing, Inc. Valmont - Virginia Galvanizing, Inc. Valmont Coatings, Inc. Valmont Composite Structures, Inc. Valmont International Corp. Valmont International LLC Valmont Newmark, Inc. Valmont Northwest, Inc. Valmont Pittsburgh Galvanizing, Inc. Valmont Service Centers, Inc. Valmont Structures, Inc. Valmont Substations LLC (pka KC Utility Structural Engineering, LLC and KC Utility Packaging LLC) Valmont West Coast Engineering Ltd. Walpar Holdco LLC Walpar, LLC (DE) Valley Science and Engineering, Inc. (pka Cascade Earth Sciences Ltd.) Valmont Infrastructure Services, Inc. (pka Matco Services, Inc.) Valmont Solar, Inc. Prospera Technologies, Inc. Cordoba Technologies, Inc. ConcealFab, Inc. ACORD 101 (2008/01)© 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD