HomeMy WebLinkAboutTotal Concrete Services Inc - Insurance Certificate 2025 A H CERTIFICATE OF LIABILITY INSURANCE DATE IMM/03/07/2025 Y)
025
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.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) mst 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 CONIACT
NAME: CLIENT CONTACT CENTER
FEDERATED MUTUAL INSURANCE COMPANY PHONE A
HOME OFFICE:P.O.BOX 328 IA/C,No,Ext):888-333-4949 (A/C,No):507-446-4664
OWATONNA,MN 55060 ADORESs:CLIENTCONTACTCENTER@FEDINS.COM
INSURERS AFFORDING COVERAGE NAIC//
INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935
INSURED INSURER B:FEDERATED SERVICE INSURANCE COMPANY 28304
TOTAL CONCRETE SERVICES INC
INSURER C:
4462 HILLTOP RD
LONGMONT,CO 80504-9681 INSURER 0:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:28 REVISION NUMBER:0
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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS
LTR INSR WVD MMIDDIYYYV MM/DDIYYYV
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000
CLAIMS-MADE TOCCUR DAMAGE TO RENTED PREMISES $100,000
(Ea occurrence
MED EXP(Any one person) $5,000
B Y N 9820205 04/01/2025 04/01/2026 PERSONAL IL ADV INJURY $1,000,000
OEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
X POLICY ECT 1-1LOC PRODUCTS 6 COMPIOP ACC $2,000,000
OTHER: ILL���FF"
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
(Ea accident) $1,000,000
JANYAUTO BODILY INJURY(Par Parson)
BOWNED AUTOS ONLY N N 9820205 04/01/2025 04/01/2026 BODILY INJURY(Per Accident)
HIRED AUTOS ONLYJASCHOEOULED
NON-OWNED PROPERTY DAMAGE
AUTOS ONLY (Per Acciden
X UMBRELLA LAB X OCCUR EACH OCCURRENCE $10,000,000
A EXCESSLIAB CLAIMS-MADE N N 9820208 04/01/2025 04/01/2026 AGGREGATE $10,000,000
DED I RETENTION
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY YIN X I PER STATUTE I OTHER
ANY PROPRIETORIPARTNER/EXECUTIVE
B OFFlCER/MEMBER EXCLUDED? N N/A N 9820209 04/01/2025 04/01/2026 E.L EACH ACCIDENT $1,000,000
(Mandatory In NH) E.I.DISEASE EA EMPLOYEE $1,000,000
If yes.describe under
DESCRIPTION OF OPERATIONS beloW E.L DISEASE POLICY LIMIT $1,000,000
POLLUTION LIABILITY N N 9820207 04/01/2025 04/01/2026 EA POLL INCIDENT $1,000,000
A r REGATE $2,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached II more space Is required)
SEE ATTACHED PAGE
CERTIFICATE HOLDER CANCELLATION
CITY OF FT COLLINS
281 N COLLEGE AVE 28 0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
FORT COLLINS,CO 80524-2404 BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE J
Q 1988-2015 ACORD CORPORATION.All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD