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Home My WebLink AboutLAFARGE WEST - INSURANCE CERTIFICATE (2)ACORQ,a CERTIFICATE OF LIABILITY INSURANCE o4ioli2oos ATE(M zoo7' PRODUCER LOCKTON COMPANIES, LLC-i KANSAS CITY THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 444 W. 47th Street, Suite 900 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Kansas City Mo 64112-1906 ALTER THE COVERAGE AFFORDED BY THE POL (816) 960-9000 INSURERS AFFORDING COVERAGE INSURED INSURER A: AMERICAN HOME ASSURANCE CO. 1060502 LAFARGE WEST, INC. NORTHERN PAVING INSURER B: NATIONAL UNION FIRE INS CO. 1800 N. TAFT HILL ROAD INaUBER C INS CO. STATE OF PA FORT COLLINS CO 80521 INSURER D ILLINOIS NATIONAL INS. CO. ^^W=M A r A c Tint ry THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY OD IDICA PERINTED. 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD/YY POLICY EXPIRATION DATE MMIDD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A X COMMERCIAL GENERAL LIABILITY X1 CLAIMS MADE 1:1OCCUR 5836153 04/01/2007 04/01/2008 FIRE DAMAGE (Any one fire $ 500,000 MED EXP An oneperson) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ Z O00 000 GEN'L AGGREGATE LIMIT APPLIES PROT X POLICY F JEC PER: LOC PRODUCTS- COMP/OP AGG $ 2,000,000 AUTOMOBILE LIABILITY A A B ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS 6074990(AOS) 6075856(MA) 6075$57 OR - +"' s, T7 �,UU/' 04/ /2008 y COMBINED SINGLE LIMIT (Ea accident) $ 2,000,000 X RODILV INJURY (Per person) S XXXXXXX X BODILY INJURY (Per accident) $ XXXXXXX A HIRED AUTOS NON -OWNED AUTOS-. 6075858 (VA) "i-':" /-"` X l .a`�1'T,,��P4nn. rirte PROPERTY DAMAGE (Per accident) $ XXXXXXX GARAGE LIABILITY R1S H AUTO ONLY - EA ACCIDENT $ XXXXXXX ANY AUTO NOT APPLICABLE OTHER THAN EA ACC AUTO ONLY: AGG $ XXXXXXX $ XXXXXXX EXCESS LIABILITY OCCUR CLAIMS MADE NOT APPLICABLE EACH OCCURRENCE S XXXXXXX AGGREGATE $ XXXXXXX $ XXXXXXX ❑UMBRELLA XXXXXXX DEDUCTIBLE FORM $ XXXXXXX RETENTION $ C B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY 2921410 (AOS) 2921416 (OR) 04/01/2007 04/01/2008 X WC STATuj E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE- EA EMPLOYEE $ 2,000,000 C 2921417 (Wl)/2921415 (NJ) E.L. DISEASE - POLICY LIMIT $ 2 OOO 000 A 2921411 CA D D D OTHER WORKERS COMPENSATION 2921412(FL) 2921414 (MI) 2921413 (LA, ND, OH, WA, WV, WY) DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ASPHALT OVERLAY PROJECT BID NO. 5839 2006 RENEWAL. RE: CITY OF FORT COLLINS IS ADDITIONAL INSURED (EXCEPT ON WORKER'S COMP) AS RESPECTS OPERATIONS OF THE NAMED INSURED WHERE REQUIRED BY WRITTEN CONTRACT. 2544641 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF FORT COLLINS DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 PO BOX 580 DAYS WRITTEN FORT COLLINS CO 80522-0580 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25-S (7/97) Forquestions regarding this certificate, wntactfles numtar Rated in the 'PmdumV section atove and spacify the chent cde'LAFNWI'. a AE0415 mRP0RATInM1oRR ACORD. CERTIFICATE OF LIABILITY INSURANCE 04/01/2008 DATE (MM/Y) 03/28/2002007 PRODUCER LOCKTON COMPANIES, LLC-1 KANSAS CITY 444 W. 47th Street, Suite 900 Kansas City Mo 64112-1906 (816)960-9000 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE INSURERS AFFORDING COVERAGE INSURED LAFARGE NORTH AMERICA, INC. 1060502 LAFARGE WEST, INC. 1800 N. TAFT HILL ROAD FORT COLLINS CO 80521 INSURER A: AMERICAN HOME ASSURANCE CO. INSURER B : NATIONAL UNION FIRE INS CO. INr2uREB Q INS CO. STATE OF PA INSURER D ILLINOIS NATIONAL INS. CO. rnu rt1 VCvnw.1C Vt' IIYJVnArmt cUVGJ nut I.UN.7 IUICA SUN 1HAUta I t 1 WCCN 1MC IS,UIN(i COVERAGES 1.AFNnn1 FK ILIC"MC010% AIMUnOMCIN oco130 0UVAt111C no 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MWDD/YY POLICY EXPIRATION DATE MMIDDNY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 FIRE DAMAGE (Any one fire $ 500 000 A X COMMERCIAL GENERAL LIABILITY X I CLAIMS MADE 1:1OCCUR 5836153 04/01/2007 04/01/2008 MED EXP (Any oneperson) $ $ 000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICYFI JECOT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 ' AUTOMOBILE LIABILITY A ANY AUTO 6074990(AOS) 04/01/2007 04/01/2008 COMBINED SINGLE LIMIT (Ea accident) $ 2,000,000 A ALL OWNED AUTOS 6075856 (MA) a X B SCHEDULED AUTOS 6075857 (OR) J i y �+ •fJ', OILY INJURY r person) $ XXXXXXX A HIRED AUTOS NON -OWNED AUTOS 6075858 (VA) nrj(T'�I 7 X BODILY INJURY (Per accident) $ XXXXXXX X - T ate• I IN4 PROPERTY DAMAGE (Per accident) $ XXXXXXX GARAGE LIABILITY RISK MA. NCi-:1,IFNI AUTO ONLY - EA ACCIDENT $ XXXXXXX ANY AUTO NOT APPLICABLE OTHER THAN EA ACC $ XXXXXXX $ XXXXXXX AUTO ONLY. AGG EXCESS LIABILITY OCCUR CLAIMS MADE NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX AGGREGATE $ XXXXXXX $ XXXXXXX ❑ UMBRELLA XXXXXXX DEDUCTIBLE FORM S XXXXXXX RETENTION S C WORKERS COMPENSATION AND 2921410 (AOS) 04/01/2007 04/01/2008 j{ WC STATU- OTH- Imli ER B EMPLOYERS' LIABILITY 2921416 (OR) E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 C 2921417 (WI)/2921415 (NJ) E.L. DISEASE- POLICY LIMIT $ 2,000,000 A 2921411 CA D D D OTHER WORKERS COMPENSATION 2921412(FL) 2921414 (MI) 2921413 (LA, ND, OH, WA, WV, WY) DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS RE: CITY OF FORT COLLINS - ASPHALT OUTSIDE SALES. 2219120 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF FORT COLLINS DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN P. 0. BOX 580 FORT COLLINS CO 80522-0580 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25-S (7/97) For questions reganlingthis wrti/irate, contact thenun"rlistedinthe'Producer'sectionaboveandsieitytheclientcode'LAFNOe/'. a AE'005 CORPORATIONIQlt ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM,DD/YY) 04/01/2008 1 03/28/2007 PRODUCER LOCKTON COMPANIES, LLC-1 KANSAS CITY THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 444 W. 47th Street, Suite 900 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Kansas City Mo 64112-1906 ALTER THE COVERAGE AFFORDED BY THE POLICIES RFI OW. (816)960.9000 INSURERS AFFORDING COVERAGE INSURED INSURER A: AMERICAN HOME ASSURANCE CO. 1060502 LAFARGE NORTH AMERICA, INC. LAFARGE WEST, INC. INSURER B: NATIONAL UNION FIRE INS CO. 1800 N. TAFT HILL ROAD INSURER C INS CO. STATE OF PA FORT COLLINS CO 80521 ILLINOIS NATIONAL INS. CO. rnvoo ArM10 T A C TnAI cv THIS CERTIFICATE RE INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING Y 1 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTRTYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MWDDNY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A X COMMERCIAL GENERAL LIABILITY 5836153 04/01/2007 04/01/2008 FIRE DAMAGE (Any one fire $ 500,000 X D CLAIMS MADE OCCUR MED EXP (Any oneperson) $ $ 000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PRO - JECT LOC AUTOMOBILE LIABILITY , `'�, c �„ A ANY AUTO 6074990 (AOS) ( ` } ?y�„_` �d �/��1�/�1��U 5+) 1 (04/ /2W OMBINED SINGLE LIMIT (Ea accitlent) $ 2+000+000 X A ALL OWNED AUTOS 6075856 (MA) B SCHEDULED AUTOS 6075857 (OR) i BODILY INJURY (Per person) $ XXXXXXX X A HIREDAUTOS 6075858 (VA) f jY1j\ODILY INJURY $ XXXXXXX X NON -OWNED AUTOS 'y r (Per accident) Cl T c RISK PROPERTY DAMAGE $ XXXXXXX (Per accident) GAR AGE LIABILITY AUTO ONLY - EA ACCIDENT $ XXXXXXX ANY AUTO NOT APPLICABLE OTHER THAN EA ACC $ XXXXXXX $ XXXXXXX AUTO ONLY: AGG EXCESS LIABILITY EACH OCCURRENCE $ XXXXXXX AGGREGATE $ XXXXXXX OCCUR CLAIMS MADE NOT APPLICABLE $ XXXXXXX ❑ UMBRELLA XXXXXXX DEDUCTIBLE FORM RETENTION $ $ XXXXXXX C WORKERS COMPENSATION AND 2921410(AOS) 04/01/2007 04/01/2008 X WCSTAI UIMI- j OTH- B EMPLOYERS' LIABILITY 2921416 (OR) E.L. EACH ACCIDENT $ 2,000,000 C 2921417 (WI)/292141$ (NJ) E.L. DISEASE - EA EMPLOYEE $ Z 000 000 A 2921411 CA E.L. DISEASE -POLICY LIMIT $ 2,000,000 D OTHER 2921412(FL) D WORKERS COMPENSATION 2921414 (MI) D 2921413 (LA, ND, OH, WA, WV, WY) DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: 2004 MATERIAL SALES. CERTIFICATE HOLDER IS AN ADDITIONAL INSURED (EXCEPT ON WORKERS' COMP) AS RESPECTS OPERATIONS OF THE NAMED INSURED WHERE REQUIRED BY WRITTEN CONTRACT. WAIVER OF SUBROGATION IN FAVOR OF THE CERTIFICATE HOLDER IS PROVIDED ON THE WORKERS' COMP. POLICY. "THIS INSURANCE IS PRIMARY AS RESPECTS THE NEGLIGENCE OF LAFARGE WEST, INC./LAFARGE. COVERAGE IS EXTENDED ONLY AS RESPECTS LAFARGE WEST, INC./LAFARGE'S NEGLIGENCE." 2216173 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF FORT COLLINS BOX DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3U P. 0. BOX 580 DAYS WRITTEN FORT COLLINS CO B0522 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD25-S(7/97) For questions regarding thiscertifcate,cerrtactthenumi,erlistedinthe'Producer' sectionaboveaMspecitylhecllantcode'LAF11001'. aA n rnRP()RATInIJIORA ACORD. CERTIFICATE OF LIABILITY INSURANCE o4/oli2oo8 03/28 2007 PRODUCER LOCKTON COMPANIES, LLC-1 KANSAS CITY THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 444 W. 47th Street, Suite 900 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Kansas City Mo 64112-1906 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (816)960-9000 INSURERS AFFORDING COVERAGE INSURED LAFARGE NORTH AMERICA, INC. INSURER A: AMERICAN HOME ASSURANCE CO. 1060502 LAFARGE WEST, INC. INSURER B: NATIONAL UNION FIRE INS CO. 1800 N. TAFT HILL ROAD INSURER C: INS CO. STATE OF PA FORT COLLINS CO 80521 iusuRER D ILLINOIS NATIONAL INS. CO. rnvcntk _lf� T A c Tt AI Uv THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR AjiL TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE M POLICY EXPIRATION DATE MWDD/VV LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 FIRE DAMAGE (Any one tiro $ 500,000 A X COMMERCIAL GENERAL LIABILITY X1 CLAIMS MADE OCCUR 5836153 04/01/2007 04/01 /2008 MED EXP (Any oneperson) $ 5 000 PERSONAL & ADV INJURY $ 2 OOO 000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE X POLICY LIMIT APPLIES JERCOT PER: LOC PRODUCTS- COMP/OP AGG $ 2,000,000 AUTOMOBILE LIABILITY A ANY AUTO 6074990 (AOS) 04/01/2007 04/01/200$ COMBINED (Ea accidentSINGLE LIMIT $ 2,000,000 A X ALL OWNED AUTOS 6075856(MA) B SCHEDULED AUTOS -,; 4751 ,I'�s'R1 6075857 (OR) j BODILY INJURY (Per person) S XXXXXXX I I \\/ I L/I• X A HIRED AUTOS 6075858 (VA) "'---_++�-'-);� 11.1E \Vy ILLry11• NON -OWNED AUTOS BODILY INJURY (Per accident) S XXXXXXX X PROPERTY DAMAGE (Per accident) $ XXXXXXX (� 2007 GARAGE LIABILITY �!'_:'?�' •; j)- i� JVR'T COLLINSAUTO ONLY - EA ACCIDENT $ XXXXXXX OTHER THAN EA ACC $ XXXXXXX ANY AUTO NOT APPLICABLE ,;.:� �A,NAGE'vIENT - $ XXXXXXX AUTO ONLY: AGG EXCESS LIABILITY OCCUR CLAIMS MADE NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX AGGREGATE S XXXXXXX $ XXXXXXX ❑ UMBRELLA XXXXXXX DEDUCTIBLE FORM S XXXXXXX RETENTION $ C WORKERS COMPENSATION AND 2921410 (AOS) 04/01/2007 04/01 /2008 X WC STATUTORY- OTH- rg B EMPLOYERS' LIABILITY 2921416 (OR) E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE -EA EMPLOYEE S 2 000 O00 C 2921417 (WI)/2921415 (NJ) E.L. DISEASE - POLICY LIMIT $ 2,000,000 A 2921411 CA D D D OTHER WORKERS COMPENSATION 2921412(FL) 2921414 (MI) 2921413 (LA, ND, OH, WA, WV, WY) DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS RE: 2002 SERVICE AGREEMENT. 2219121 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF FORT COLLINS DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 P. 0. BOX 580 DAYS WRITTEN FORT COLLINS CO 80522 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD25-S(7/97) For questions mgarding this certificate, mnlact the numiner listed In Me 'Pnducee section shave and spwity the client ccde 'LAFNOOI 95A O COR PORATION 1 QAA ACORDN CERTIFICATE OF LIABILITY INSURANCE o4ioli2ooa o ii8iaoo7' PRODUCER LOCKTON COMPANIES, LLC-1 KANSAS CITY 444 W. 47th Street, Suite 900 Kansas City Mo 64112-1906 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED E IES BELOW. INSURERS AFFORDING COVERAGE (816) 960-9000 INSURED LAFARGE NORTH AMERICA, INC. 1060502 LAFARGE WEST, INC. INSURER A: AMERICAN HOME ASSURANCE CO. INSURER B : NATIONAL UNION FIRE INS CO. INSURER c INS CO. STATE OF PA 1800 N. TAFT HILL ROAD FORT COLLINS CO 80521 INSURER D ILLINOIS NATIONAL INS. CO. nnVPRAnPQ T AT WI —I II RTC l Hl5 "It UrA;AI r UH INSUHANCE UUE5 NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MWDDNY I POLICY EXPIRATION DATE MWDDIYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 FIRE DAMAGE (Any one fire $ 500000 A X COMMERCIAL GENERAL LIABILITY 5836153 04/01/2007 04/01/2008 X 1:1OCCUR CLAIMS MADE MED EXP (Any oneperson) $ 5 000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 2 00O O00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ 2 OOO OOO X POLICY JERCOT LOC AUTOMOBILE LIABILITY A ANY AUTO 6074990 (AOS) 4 r �.@OR.i COMBINED SINGLE LIMIT Ea accident) $ 2,000,000 A X ALL OWNED AUTOS 6075856 (MA) B SCHEDULED AUTOS 6075857(OR) p.. Qfin`r. BODILY INJURY (Per person) S XXXXXXX A X HIREDAUTOS 6075858 (VA) f X NON -OWNED AUTOS Ti OF FCO�) _ -.INS BODILY INJURY (Per accident) S XXXXXXX PROPERTY DAMAGE $ XXXXXXX RISKMfi``r" - "' a (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ XXXXXXX ANY AUTO NOT APPLICABLE OTHER THAN EA ACC $ XXXXXXX $ XXXXXXX AUTO ONLY: AGO EXCESS LIABILITY EACH OCCURRENCE S XXXXXXX OCCUR CLAIMS MADE NOT APPLICABLE AGGREGATE S XXXXXXX S XXXXXXX El XXXXXXX DEDUCTIBLE FORM $ XXXXXXX RETENTION $ C WORKERS COMPENSATION AND 2921410 (AOS) 04/01/2007 04/01/2008 X WC STATU- I OTH- rg B EMPLOYERS' LIABILITY 2921416 (OR) $ 2,000,000 E.L. EACH ACCIDENT E.L. DISEASE- EA EMPLOYEE $ 2,000,000 C 2921417 (WI)/2921415 (NJ) E.L. DISEASE - POLICY LIMIT $ 2,000,000 A 2921411 CA D OTHER 2921412(FL) D WORKERS COMPENSATION 2921414 (MI) D 2921413 (LA, ND, OH, WA, WV, WY) DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: ASPHALT OVERLAY PROJECT. CERTIFICATE HOLDER IS AN ADDITIONAL INSURED (EXCEPT ON WORKERS' COMP) AS RESPECTS OPERATIONS OF THE NAMED INSURED WHERE REQUIRED BY WRITTEN CONTRACT. WHERE REQUIRED BY WRITTEN CONTRACT, WAIVER OF SUBROGATION IN FAVOR OF THE CERTIFICATE HOLDER IS PROVIDED ON THE WORKERS' COMP. POLICY. "THIS INSURANCE IS PRIMARY AS RESPECTS THE NEGLIGENCE OF LAFARGE WEST, WC./LAFARGE. COVERAGE IS EXTENDED ONLY AS RESPECTS LAFARGE WEST, INC./LAFARGE'S NEGLIGENCE." 2216174 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF FORT COLLINS BO P. 0. BOX DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 X 580 DAYS WRITTEN FORT COLLINS CO 80522 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25—S (7/97) For gaestions rega ding this certificate, wntad the number llstad in the'Protiuc.e section abovs and speeltythe client code'LAFNODP. a, A -O rnaait)RATION I citsk