HomeMy WebLinkAboutVOGEL CONCRETE - INSURANCE CERTIFICATE (10)Client#- 39603
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ACORDTM CERTIFICATE OF LIABILITY INSURANCE
DATE (MI
5/24/05DOmrr)
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4821 Wheaton Drive
P O Box 270370
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins, CO 80527
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
Vogel Concrete Inc.
1313 Blue Spruce Dr #B
Fort Collins, CO 80524
INSURERA: Plnnacol Assurance
INSURER B:
INSURER C:
INSURER D:
INSURER E:
COVERAGES
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.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MWDD/YY
POLICY EXPIRATION
DATE MWDDIYY
LIMITS
1
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FIOCCUR
EACH OCCURRENCE
$
DAMAGE TO RfEaENTEDOccurrence)
$
MED EXP (Any one person)
$
PERSONAL B ADV INJURY
$
GENERAL AGGREGATE
$
GENT AGGREGATE LIMIT APPLIES PER:
POLICY PRO- LOC
1-1JECT
PRODUCTS - COMP/OP AGG
$
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
(a acccidentSINGLE LIMIT
$
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
EXCESSIUMBRELLA LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
$
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
2086850
07/01/04
07/01/05
X WC STATU- OTH-
TOR IT
E.L. EACH ACCIDENT
$100,000
E.L. DISEASE - EA EMPLOYEd
$100,000
E.L. DISEASE - POLICY LIMIT I
$500,000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
CERT
City of Ft Collins Purchasing Dept
Attn: John Steven
PO Box 580
Fort Collins, CO 80522
LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _3(11 DAYS WRITTEN
E TO THE CERTIFICATE HOLDER NAMEp TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OSLIGA'%ON OR LIABILITY j6F PAY KIND tFON THE INSURER, ITS AGENTS OR
ACORD 25 (2001/08) 1 of 2 #S315686/M285322 D ACORD CORPORATION 1988
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
A%,VKu zo-s tzuuvun) 2 of 2 #S315686/M285322