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Home My WebLink About102511 LAFARGE NORTHERN INC - INSURANCE CERTIFICATE (3)iw%A4 : �° st ' ;" � IA 7 kl'n lL � [A:CORD_ TYJ IRFIC E„I t S3 N�PI}U41 '"'r�i(;;'t DATE (lMqM//oD4D//zVoVoV?Y) PRODUCER AOn Risk services, Inc. of Pennsylvania One Liberty Place 1650 Market Street Suite 1000 Philadelphia PA 19103 USA PxoN'e-(866) 283-7122 FAX- 847 953-5390 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 POLICIES BELOW. INSURERS AFFORDING COVERAGE I NAIC# INSURED Lafarge west, Inc 1800 North Taft Hill Road, Fort Collins CO 80521 USA INSURER AAmerican Home Assurance Co. 19380 INSURER B, National union Fire Ins Co of Pittsburgh 19445 INSURER C: Insurance Company of the State of PAI 19429 INSURER IN Illinois National Insurance co 23817 INSURER E'. I .CJ nY„-s,...y -1,74a2'L" ` *:$:-„77 7 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 NDWI INSRD TYPEOPINSURANCE POLICVNUMBER IHIL CV EFFECTIVE DATEEMINEDWIT) POLICY EXPIRATION DA'IT(MMVDDAYY) LIMITS A F.NERAL X X LIABILITY1595365 COMMERCIALGENERALLIABILITY CLAIMS MADE: 0 IX'CUR (VA/CM) 07/01/07 07/01/08 EACH OCCURRI S2,000,000 DAMAGE (E REM'GD PREMISE(Aovone $500,000 Denson MEU b:XP IAnv ane Person) 5, PERSONAL@ ADV INJURY $2,000,000 GENERAL AGGREGATE $2,000,000 GENT, AGGREGATE LIMIT APPLIES PER POLICY CI �� LOC El PRODUCTS - COMPIOP AGO E2,000,000 A A a A AUTOMOBILE X X LIABILITY AN) AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON CANTO AUTOS 1606931 1606932 (MA) 1606933 (OR) 1606934 (VA) 07/01/07 07/01/07 07/01/07 07/01/07 07/01/08 07/01/08 07/O1/OB 07/01/08 COMBINED SINGLE LIMIT (EzoaidenD S2,000,000 BODILY INJURY ( Per person) X X BODILY INJURY (Per accidenD PROPERTY DAMAGE (Per.6dent) CA RAG E LIARI LI'I'Y B ANY AUTO AUTO ONLYEAACCIDENT ACT0 NI-Y EA ACC AVIOONLI". AGG EXCESS ATM BRELIA LWBI IT ❑ OCCUR ❑ CLAISIS MADE eDEDUCTIBLE RETENTION EACH OCCURRENCE AGGREGATE C A 0 A D C WORKERS COMPENSATION AND W' E>iPLO\'F.RS'LIAtlILITY AN1'PROPRIETOR / PARTNER /L:(GCIID\'E OFFICER/MEMBER EXCLUDED? Ifyes. Describe wJer SPECIAL PROVISIONS bebw 1616288 ADS 1616290 (CA) 1616291 (FL) 1616291 (LA,PtC) 161629(N) 1616293 (NJ) 7 07/01/07 07/01/07 07/O1/07 07107 07/0/O1/07 07/01/08 07/01/08 07/O1/08 07/1/08 07/01/08 J( JWC STATH- 1 ACCI OTI ER EL. EACH ACCIDENT E2,000,000 EL. DISEASE EA IiMPLOYF.F, $2, 000, 000 G.L. DISEASEVOLICY LIMIT' $2, 000,000 OTHER DESCRIPTION OF OPERATIONMACATIONSATHICI FIX EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS RE: CITY OF FORT COLLINS - ASPHALT OUTSIDE SALES. CERTIFICATEIHOLDERN_A,Y. MCANCELLATION s""x. CITY OF FORT COLLINS P.O. BOX 580 FORT COLLINS CO 80522-0580 USA 30 SHOULD ANY OF TI IE ABOVE. DESCRIBED POLICIES I317 CANCELLED BEFORE I I IF:EXPIRATION DATE THEREOF. I IF. ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS VVEM EN NO I' ICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE1 O DO SO SHALL IMPOSE NO OBLIGATION OR LIARI CITY OF ANY KIND UPON FOR INSURER. ITS AGSM S OR REPRESENT ATI VFS. AT I IORIZED REPRESENT A'I I VE r..r,...=.T: €1 '1:--1 kCORDTORPORATION4988 G Attachment to ACORD Certificate for Lafarge west, Inc The terms, conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the coverage afforded by the insurer(s). This attachment does not contain all terms, conditions, coverages or exclusions contained in the policy. INSURED Lafarge west, Inc 1800 North Taft Rill Road, Fort Collins Co 80521 USA ADDITIONAL POLICIES If a policy below does no INSURER INSURER include limit information, refer to the corresnondiov nnticv nn the certificate form for policy limits. INSR LTR ADD'L INSRD TYPE OF INSURANCE POLICY'.NUMRER POLICY DESCRIPTION POLICY EFFECTIVE DATF. POLICY EXPIRATION DATE LIMITS WORKERS COMPENSATION O 1616294 (OR) 07/01/07 07/01/08 C 1616295 (wi) 07/01/07 07/01/08 DESCRI 10N OF OPERAIIONS20CATIOBSNF,IIICLESTXCLUSIONS ADDED a\EN'DORSEMENT/SPECIAL PROY'ISION'S Certificate No : 570025451156 )/ II I;n, NI§tH1{, tE Elf- PFtirl I +'i.,'S`lPbFE ih11 y �E '}t;ptli BI`flpi ACORD CE' [FICAT E OFF I vIABIL`IT_ �. .. f 71lLNv *J rI 4t lw ca �5, t PjCull. IjR y I}I {r tP ?L DATE(MM/DD/YYYY) Y,'INSURANCE PRODUCER Aon Risk Services, Inc. of Pennsylvania One Liberty Place THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 1650 Market Street CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE Suite 1000 COVERAGE AFFORDED BY THE POLICIES BELOW. Philadelphia PA 19103 USA INSURERS AFFORDING COVERAGE NAICN PHONE- 866 283-7122 FnX- g47 953-5390 INSURED INSURER A: American Home Assurance Co. 19380 INSURER B. National union Fire Ins Co of Pittsburgh 19445 Lafarge West, Inc 1800 North Taft Hill Road, Fort Collins CO 80521 USA INSURERC Insurance Company of the State Of PAI 19429 INSURER D, illinoiS National insurance Co 23817 INSURER E: itCOVERAGESf, THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE MSURED 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 ADD-1 INSRD TSPE OF INSURANCE POLIC1'NU.MBER POLICY F.FFECTWE DATE(MMUM]nVY) POLICY'EXPIRA'1'[ON DA'I'E(MMDD\Y'Y) LIMITS A NERAL LIARILITV 1595365 (VA/CM) 07/01/07 07/01/08 EACH OCCURRENCE $2,000,000 DAMAGE TO RENTED PREMISES IEa owarmce) $500,000 X COMMERCIALGENERALLIABILITY 'X CLAIMSMADE OCCUR 9 MEDEXPIAnvoneoemnl PERSONAL& ADV INJURY $2,000,000 GENERAL AGGREGATE $2,000,000 GENE AGGREGATE LIMIT APPLIES PER: PRODUCTS - COFff/OP AEG 52, 000,000 InPOLICY ❑ I� LEE JPRO ECT A A B AUTOMOBILE X LIABILM ANY ALTO 1606931 1606932 (MA) 1606933 (OR) 07/01/07 07/01/07 07/01/07 07/01/08 07/01/08 07/01/08 COMBINED SINGLE LIMIT (Ea acci&n1) $2,000,000 BODILY INJURY A X ALL OWNED AUTOS 1606934 (VA) 07/01/07 07/01/08 SCHEDULED AUTOS (Pe1 Pe.r) X HIRED AUTOS BODILY INJURY X NON OWNED AUTOS (Per in.dm) PROPERTY DAMAGE (Per acciden) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT ANY AID0 OTHER '1'IIAN EA ACC e AMOONLY: AGO F_XCFSSNpIBRELLA LIABILITY EACH OCCURRENCE ❑ OCCUR ❑ CLAIMS MADE, AGGREGATE, BDEDUCTIBLE RETF,NTIOR C A 0 WORKERS COMPENSATION ANU EMPLOYERS' LIARILM' A05 1616289 (CA) 1616291 (FL) 07/01/07 07/01/07 07/01/08 07/01/08 X WC S'I ATU- LS O'IH. E L EACH ACCIDENT $2,000,000 A 0 C / E(ECIIII\'E OANYFFI PROPRIETOR / EXCLUDED' OFFlCERMEMBER EXCLUDIiD? vyes, desCine ender SPECIAL raoYlsoNs blow 1616291 (LA,eu) 1616292 (MI) 1616293 (ND) 07/Ol/07 07/01/07 07/01/07 07/Ol/08 07/01/08 07/01/08 [L. DISEASE -FA EMPLOYEE E2,000,000 E.L. DISEASE -POLICY LIMA' 82,000,000 OTHER DESCRI VIION OF OPERATIONS/LOCATIONS/VIi HICLESTXCLUSIONS ADDED BY ENDORSEMENI'/SPECIAI, PROVISIONS SOUTH LEMAY AVENUE WIDENING PROJECT. RE: CITY OF FORT COLLINS IS ADDITIONAL INSURED (EXCEPT ON WORKERS AS COMP) RESPECTS OPERATIONS OF THE NAMED INSURED WHERE REQUIRED BY WRITTEN CONTRACT CER7'IFI CATE`7iOLDERIw,.,!'lmgll"q %i1,,,9udMIfINiN i. :v. tt"..i CITY OF FORT COLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 215 NORTH MASON STREET, 2ND FLOOR FORT COLLINS CO SOS24 USA 30 DATE THERIiOETHE ISSUING INSURER WILLENDEAVOR TO MAD. DAYS W'RI'ITBN NOT ICE TO THE CERTIFICATE HOLDER NAMED'10 THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILH Y OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTnI'IVE AC RD21 2007/ ". ' �' • 'i5`. .)'1 rJ+,11 ;= "fi . a' xi ,•:;_¢ ..�_+� 3'r"; :.. e...`3 , .:`4 e x. ... ," ~t. IJ-i• 'e RD CORP RA I N)]. C: Attachment to ACORD Certificate for Lafarge West, Inc The terns, conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the coverage afforded by the insurer(s). This attachment does not contain all terms, conditions, coverages or exclusions contained in the policy. INSURED Lafarge West, Inc 1800 North Taft Hill Road, Fort Collins CO 80521 USA ADDITIONAL POLICIES INSURER INSURER If a policy below does not include limit information, refer to the corresponding policy on certificate forth for policy limits. 4r01N1P LTR IgR ADD', INSRD '1'1'I'EOFINSURANCE PO1.10'NUMBER POLICI'Uf:SCN1 VI'1(IN POLIO' EFFEC'HVE UA'1'F: POLICY EXPIRATION UATF. LIMI'Iti WORKERS COMPENSATION D 16162§4 (OR) 07/01/07 07/01/08 c 1616295 (wi) 07/01/07 07/01/08 DESCRIITION OF OPERATIONSTO(:ATIONSNEI HCLES/P.xC I.US IONS ADDED B\12NDORSEMEN'I/SPECIAL PRO\'ISIONS Certificate No: 570025452598 AON Aon Risk Seriices L ORIIVIWIC Cteet Smile Representali i e telephone 847-953-7052 maul 866-2813-7122 fin 800-363-0105 enunl ion I urns @m s aon toot October I, 2007 To Whom It May Concern Insurance Certificate Holder Re: Amended Certificate Of Insurance To Whom It May Concern Enclosed please find an amended certificate of Insurance for the current insurance This certificate of insurance replaces the certificate previously sent to you Please the certificate previously provided Please feel free to contact me with any questions Best Regards, Lori Vismc Client Service Repiesentative Aon Risk Services, Inc Aon RnA Sen , s In, 1000 M 1,,mk« A, III UL (liens III' IL 6002i . id 866-281-7122 • Ia, 800 163-010i