HomeMy WebLinkAboutAlpha Milling Company, Inc. - Insurance Certificate,acoRO� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)
`� 1/1/2025 07/11/2024
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CER7IFICATE 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 N
8110 E Union Avenue PHONE F
N E '
$Uli2 100 E-MAIL
Denver CO 80237
(303) 414-6000 INSURER S AFFORDING COVERAGE NAIC #
ir+suReRA: Executive Risk Indemnity Inc. 35181
INSURED Alpha Milling Company, If1C. INSURERB: F2d2�8I IIISUra1lC2 COfll an 20281
53O%92 6015 W 56th Avenue INSURER C: I r m m � s. In . � J4HJ
Arvada CO 80002 iNsuReR o: Endurance American Insurance Com an 10641
INSURERE: NBVI ators S ecialt Insurance Com an 36056
INSURER F :
COVERAGES CERTIFICATE NUMBER: 20107276 REVISION NUMBER: XXXXXXX
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY
PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO
WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO
ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDL SUB POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/OD/YYYY MMIDD/YYYY LIMITS
A X COMMERCIALGENERALLIABILITY 54326641 O'I/O'I/ZOZ O'I/O'I/ZO2 EACHOCCURRENCE 52000000
CLAIMS-MADE � OCCUR PREMG O N rr n S 3OO OOO
Y N MED EXP An one erson S � 0 0��
PERSONAL 8 ADV INJURY 5 Z OOO OOO
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 4 OOO OOO
POLICY� PE � � ��� PRODUCTS - COMP/OP AGG 5 4 OOO OOO
OTHER: 5
B AUTOMOBILELIABILITY 54326640 01/01/202 ��/�'�/2�2 E�aBcideDSINGLELIMIT 5 2'000,000
X ANY AUTO BODILY INJURY (Per person) S XXXXXXX
OWNED SCHEDULED Y N BODILY INJURY (Per accidenQ 5 XXXXXXX
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY AMAGE
AUTOS ONLY AUTOS ONLY Peracadenl S i�i�i�i�i�i�i�
SXXXXXXX
C X UMBRELLALIAB X OCCUR 03141129 Q�/Q'�/2Q2 Q�/Q�/2Q2 EACHOCCURRENCE 5$�QQQ,QQQ
D EXCESSLIAB CLAIMS-MADE Y N ELD30050715700 O"I/O'I/ZOZ O�/O'I/ZOZ AGGREGATE � H2OOO,OOO
DED RETENTION S 5 XXXXXXX
WORKERS COMPENSATION � X H-
B ANDEMPLOYERS'LIABILITY y/N 54326642 01/01/202 01/01/202 TAT T
OFFICER/MEMBER EXCLUDED? ECUTNE N❑ N� A N E.L. EACH ACCIDENT S ��OOO�OOO
(Mandatary in NHJ E.L. DISEASE - EA EMPLOYEE S ��OOO�OOO
If yes, descnbe under
DESCRIPTION OF OPERATIONS below E.L DISEASE - POLICY LIMIT S � OOO OOO
� L/R Equip IMP30050719901 07/15/202 07/15/202 $�,000,000
E Pollution NY24ECPX01291NC 01/01/202 01/01/202 $2,000,000
� Cargo N N IMP30050719901 07/15/202 07/15/202 $�,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
City of Fort Collins is included as Additional Insured as respects General Liability, Auto Liability, and Umbrella Liability if required by written contract.
CERTIFICATE HOLDER CANCELLATION ee ttac ments
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
ZO� O%Z%s AUTHORIZED REPRESENTATIVE
City of Fort Collins
ATTN: Engineering Department
281 North College Avenue � ,-:-;%
Fort Collins, CO 80524 -_ -" , �j-} '
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