HomeMy WebLinkAboutOn-Demand Concrete LLC - Insurance Certificate 2025-2026
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED BY CONTRACT ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE PART
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by the endorsement.
A.WHO IS AN INSURED for "bodily injury" and "property damage" liability is amended to include:
Any person or organization other than a joint venture, for which you have agreed by written contract to
procure bodily injury or property damage "auto" liability insurance arising out of operation of a covered
"auto" with your permission. However, this additional insurance does not apply to:
(1)The owner or anyone else from whom you hire or borrow a covered "auto". This exception does
not apply if the covered "auto" is a "trailer" connected to a covered "auto" you own.
(2)Your "employee" if the covered "auto" is owned by that "employee" or a member of his or her
household.
(3)Someone using a covered "auto" while he or she is working in a business of selling, servicing,
repairing, parking or storing "autos" unless that business is yours.
(4)Anyone other than your "employees", partners (if you are a partnership), members (if you are a
limited liability company), or a lessee or borrower or any of their "employees", while moving
property to or from a covered "auto".
(5)A partner (if you are a partnership), or a member (if you are a limited liability company) for a
covered "auto" owned by him or her or a member of his or her household.
B.The coverage extended to any additional insured by this endorsement is limited to, and subject to all terms,
conditions, and exclusions of the Coverage Part to which this endorsement is attached.
In addition, coverage shall not exceed the terms and conditions that are required by the terms of the written
agreement to add any insured, or to procure insurance.
C.The limits of insurance applicable to such insurance shall be the lesser of the limits required by the
agreement between the parties, or the limits provided by this policy.
D.Additional exclusions. The insurance afforded to any person or organization as an insured under this
endorsement does not apply:
1.To "loss" which occurs prior to the date of your contract with such person or organization;
2.To "loss" arising out of the sole negligence of any person or organization that would not be an insured
except for this endorsement.
3.To "loss" for any leased or rented "auto" when the lessor or his or her agent takes possession of the
leased or rented "auto" or the policy period ends, whichever occurs first.
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
CA-F-127 (03-03) Policy Number: 6115485 Transaction Effective Date:04/01/2025
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS (FORM B)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
CITY OF FORT COLLINS PURCHASING DIVISION
PO BOX 580
Fort Collins, CO 80522-0580
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement.)
WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the
Schedule, but only with respect to liability arising out of "your work" for that insured by or for you.
Job or Project:
See IL-F-40-00047
Insured:
Bedrock, LLC
10813 Highway 257 Spur
Greeley, CO 80634-9001
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
CG-F-64 (06-19)Policy Number: 6115485 Transaction Effective Date: 07/30/2025
(CG 20 10 11-85)
IL-F-40-00047 Extension Endorsement
ANY COVERAGE PROVIDED BY THIS ENDORS EMENT APPLIES ONLY TO delivery and
placement of raw materials DONE BY T HE NAMED INSURED FOR THE ADDITIONAL
INSURED PERSON(S) OR ORGANIZATION(S) IN THE STATE OF CO. Subject to the
terms and conditions of the policy, Additional Insureds also includes: The
City, its officers, agents and emplo yees
IL-F-40-00047 (06-10)Policy Number: 6115485 Transaction Effective Date: 07/30/2025