Loading...
HomeMy WebLinkAbout272091 INTERMOUNTAIN SLURRY SEAL - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE OP ID DATE (MM/DD GRA-160 09 17 /04 04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Mc Sherry & Hudson ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE License #0056172 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 575 Auto Center Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Watsonville CA 95077 Phone:831-724-3841 Fax:831-724-7574 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Valley Forge Insurance Co. INSURER B: INTERMOUNTAIN SLURRY SEAL, INC INSURER C: P.O. BOX 50085 INSURER D: Watsonville CA 95077-5085 INSURER E: JERAGES V 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 EY DATEYMWDDIYY E PDATE MM/DD/YY EXPIRATION LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE 7OCCUR EACH OCCURRENCE $ PREMISES (Ea occurence) $ MED EXP (Any one person) $ PERSONAL& ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO JECT LOC PRODUCTS - COMP/OP AGG $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS TENOWDAYS111MUIBEGREN EVIX OF Pyy'L7I ATION I 1 fIL. L►GI� I VtRiG►Ilfl RRI IN THE NON-PAYMENT OF PREMIUM OR COMBINED SINGLE LIMIT (Ea accident) $ 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 $ $ EXCESS/UMBRELLA 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 WC 2 4922 5185 10/01/04 10/01/05 X I TORY LIMITS ER E.L. EACH ACCIDENT s 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 E.L. DISEASE -POLICY LIMIT $ 2,000,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES JOB #160153 PROJECT DESCRIPTION: SH 297 AND LAKE STREET MEDIAN IMPROVEMENTS - BID NUMBER: 5866 CFRTIFICATF Hnl nFR GANGtLLAI IUN FORTCOL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL 9015 X9fdpF1 11l 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, OUL CITY OF FORT COLLINS P.O. BOX 580 FORT COLLINS CO 80522-0580 -RePResemTA"m. I Mc Sherry & Hudson hl%AA' `>"if 'L I ACORD 25 (2001/08) © ACORD CORPORATION 1988