HomeMy WebLinkAbout128247 PIONEER SAND COMPANY INC - INSURANCE CERTIFICATEACORD,a'TFM7.IT
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:DATE (MMIDDIYY)
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THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Aeordia Mountain West
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Dept 1775
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver CO 80291-1775
COMPANIES AFFORDING COVERAGE
(719) 592-1177
COMPANY
A Wausau Underwriters Ins. Co.
INSURED
COMPANY
Pioneer Sand Company, Inc.
B Arch Specialty Insurance Co.
Pioneer Landscaping Materials
COMPANY
PO Box 7650
Ci Pinnacol Assurance
Colorado Springs, CO 80933
COMPANY
_.
D Fireman's Fund Insurance [n_
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELO W HA V E BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED,NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICHTHIS
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.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
LTR DATE (MMIDDIYY) DATE (MMIDDIYY) LIMITS
A GENERAL LIABILITY TZCZ91439851037 1/01/07 1/01/08 GENERAL AGGREGATE $ 2,000,000
X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ 2,000,000
CLAIMS MADE OCCUR PERSONAL S ADV INJURY $ 1,000,000
OWNER'S 8 CONTRACTOR'S PROT EACH OCCURR
ENCE
$ 1,000,000
FIRE DAMAGE (Any one fire)
$ 100,000
MED EXP (Any one person)
$ 5,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
ASJZ91439861027
1/01/07
1101/08
COMBINED SINGLE LIMIT
$
2,000,000
X
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
$
GARAGE
LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN AUTO ONLY:
EACH ACCIDENT
$
AGGREGATE
$
B
EXCESS LIABILITY
X UMBRELLA FORM
OTHER THAN UMBRELLA FORM
ULP0002265-02
1/01/07
1/01/08
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$ 1,000,000
$
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
THE PROPRIETOR/
PARTNERS/EXECUTIVE X INCL
OFFICERS ARE: EXCL
4018785(COLORADO)
2/01/06
2/01/07
X WC STATU• OTH-'
Y T
EL EACH ACCIDENT
$ 500,000
EL DISEASE -POLICY LIMIT
$ 500,000
EL DISEASE -EA EMPLOYEE
$ 500.000
OTHER
D Property/ Inland Marine MX198474176 9/01/06 1/01/08 10,000,000 per Occurrence
0 Leased/ Rented Equipment MX198474176 9/01/06 1/01/08 600,000 per Occurrence
D Motor Cargo Le al L)ab. MX198474176 9/01/06 1 1/01/08 1 100,000 Legal Liability
DESCRIPTION OF OPERATIONSA•OCATIONSWEHICLESISPECIAL ITEMS
RE: Bid #5148 Infield Soil Mix
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of Ft. Collins EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
P. 0. Box 580 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Ft. Col I Ins, CO 80522-0580 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
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1 -- S7'3'4lion Puerto 100520
CERTIFICATE: 198/001/ 00176