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Home My WebLink About102511 LAFARGE NORTHERN INC - INSURANCE CERTIFICATE (9)ACORD. CERTIFICATE OF LIABILITY INSURANCE 04/01/2006 03/23/200 ' PRODUCER Lockton Companies P 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 HE INSURERS AFFORDING COVERAGE INSURED LAFARGE WEST, INC. 1060502 NORTHERN PAVING 1800 N. TAFT HILL ROAD FORT COLLINS CO 80521 INSURERA: AMERICAN HOME ASSURANCE CO. INSURER B : NATIONAL UNION FIRE INS CO INSURER C: INS CO. STATE OF PA rnvcoer_Fs T A17MCIAI FTC 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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATEIMMID POLICY EXPIRATION DATE fMM/DD/YYI LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY ::Xl CLAIMS MADE D OCCUR GL3314756 04/01/2005 04/01/2006 EACH OCCURRENCE 2,000,000 FIRE DAMAGE (Any one fire $ 500,000 MED EXP (Anyone arson $ 5,000 PERSONAL & ADV INJURY $ 2,000.000 GENERAL AGGREGATE $ Excluded GEN'L AGGREGATE P ICY LIMIT APPLIES PR - JET PER: L PRODUCTS - COMP/OP AGG $ 2,000,000 A A A A B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULEDAUTOS HIREDAUTOS NON -OWNED AUTOS CA2651851 (AOS) CA2651853 (MA) CA2651852(TX) CA2651854 (VA) CA2651855 (OR) 04/01/2005 04/01/2006 COMBINED SINGLE LIMIT Ea accident) $ 2000000 X BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident) $ XXXXXXX PROPERTYDAMAGE (Per accident) $ XXXXXXX GARAGE LUIBILITY ANY AUTO NOT APPLICABLE AUTO ONLY - EA ACCIDENT $ XXXXXXX OTHER THAN EA ACC AUTO ONLY: AGG XXXXXXX XXXXXXX EXCESS LIABILITY OCCUR CLAIMS MADE O UMBRELLA DEDUCTIBLE FORM RETENTION $ NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX AGGREGATE $ XXXXXXX XXXXXXX XXXXXXX XXX}{Xxx C A B C WORKERS COMPENSATION AND EMPLOYERS' LLABILITY WC3599065(AOS) WC3599067 (CO) WC3599068 (OR) WC3599066 WI /WC3599069(Ni)E.L. 04/01/2005 04/01/2006 OTH- X WCSTATU- FP E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE -EABAIPOYJEE OYEE $ 2,000,000 DISEASE - POLICY LIMIT $ 2,000,000 OTHER DESCRIPTION OF OPERATIONSfLOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS THE GENERAL LIABILITY POLICY IS SUBJECT TO A PRODUCTS -COMPLETED OPERATIONS AGGREGATE ONLY. NO GENERAL AGGREGATE APPLIES AS THE POLICY WILL RESPOND TO EACH AND EVERY OCCURRENCE WITH A LIMIT OF LIABILITY SHOWN. THE CITY OF FORT COLLINS AND THE CITY OF FORT COLLINS ENGINEERING DEPARTMENT ARE ADDITIONAL INSUREDS (EXCEPT ON WORKER'S COMP) AS RESPECTS OPERATIONS OF THE NAMED INSURED WHERE REQUIRED BY WRITTEN CONTRACT. RE: ASPHALT OVERLAY PROJECT 2005 2257039 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF FORT COLLINS DATE THEREOF, THE ISSUING INSURER HALL ENDEAVOR TO MAIL 30 DAYS WRITTEN ATTN: JAMES O'NEILL PO BOX 580 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL FORT COLLINS CO 80522 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25-S (7197) For questions mprdinq this cerlMcats, contact the number listed in the'Producee section show and specify the client code'LAFNG01'. ® ACORD 6611PORATION 1998 ACORM CERTIFICATE OF LIABILITY INSURANCE 04/01/2006 03/10/20 s) PRODUCER Lockton Companies THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION P 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 COVERAGEPOLICIES (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 w R C : INS CO. STATE'OF PA FORT COLLINS CO 80521 _..___ _ T Un.T=XT T To r. COVERAGES LAFN001 FK 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 MMIDDIYY POLICY EXPIRATION DATE IMMIDDIYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE 2,000,000 FIRE DAMAGE (Any one fire $ 500,000 A X COMMERCIAL GENERAL LIABILITY :X:l CLAIMS MADE E OCCUR GL3314756 04/01/2005 04/01/2006 MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ Excluded GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICYF—1 JECT LOC A AUTOMOBILE LIABILITY ANY AUTO CA2651851 (AOS) 04/01/2005 04/01/2006 COMBINED SINGLE LIMIT (Ea accident) $ 2,000,000 X BODILY INJURY (Per person) $ XXXXXXX A A ALL OWNED AUTOS SCHEDULED AUTOS CA2651853 (MA) CA2651852 (TX) A HIRED AUTOS NON -OWNED AUTOS CA2651854(VA) CA2651855 (OR) (Per ) $ XXXXXXX PROPERTY DAMAGE (Per accident) $ XXXXXXX GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ XXXXXXX OTHER THAN EA ACC AUTO ONLY: AGG XXXXXXX ANY AUTO NOT APPLICABLE $ XXXXXXX EXCESS LIABILITY OCCUR CLAIMS MADE NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX AGGREGATE $ XXXXXXX XXXXXXX O UMBRELLA X'xj(xxxx DEDUCTIBLE FORM $ xx?(xx)Lx RETENTION $ C WORKERS COMPENSATION AND WC3599065 (AOS) 04/01/2005 04/01/2006 WCSTATUTo Y- OTH- FR A EMPLOYERS' LIABILITY WC3599067 (CO) E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2000000 B WC3599068(OR) E.L. DISEASE -POLICY LIMIT $ 2000000 C WC3599066 WI/WC3599069 N OTHER F_ DESCRIPTION OF OPERATONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS THE GENERAL LIABILITY POLICY IS SUBJECT TO A PRODUCTS -COMPLETED OPERATIONS AGGREGATE ONLY. NO GENERAL AGGREGATE APPLIES AS THE POLICY WILL RESPOND TO EACH AND EVERY OCCURRENCE WITH A LIMIT OF LIABILITY SHOWN. 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 P. 0. 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) For qu lone regarding t I* wrtifian e, wmteet tie number Ileled In tie Troducee eedlon above a %,edfy 1M client code'LAFNOat'. 0 ACORD 66IRPORATInN I9RR ACORD,a CERTIFICATE OF LIABILITY INSURANCE DATE/YY) 04/Ol/2006 03/23/20/2005 PRODUCER Companies Lockton 444 to Co 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 By THE POLICIES BELOW, (816) 960-9000 INSURERS AFFORDING COVERAGE INSURED LAFARGE WEST, INC. INSURER A: AMERICAN HOME ASSURANCE CO. INSURER B: NATIONAL UNION FIRE INS CO 1060502 NORTHERN PAVING 1800 N. TAFT HILL ROAD FORT COLLINS CO 80521 INSURER C: INS CO. STATE OF PA INSURER D : INSURER E : COVERAGES I"K 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 ITR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (MlWDDlYYl LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A X COMMERCIAL GENERAL LIABILITY X CLAIMS MADE 0 OCCUR GL3314756 04/01/2005 04/01/2006 FIRE DAMAGE (Anyone lire $ 500 000 MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ Excluded GEN'L AGGREGATE LIMIT APPLIES POLICY 17 JECTPRO- PER: LOG PRODUCTS - COMP/OP AGG $ 2,000,000 A AUTOMOBILE X LIABILITY ANY AUTO CA2651851 (AOS) 04/01/2005 04/01/2006 COMBINED SINGLE LIMIT (Eaamidenl) $ 2,000,000 A ALL OWNED AUTOS CA2651853 (MA) A SCHEDULED AUTOS CA2651852 (TX) BODILY INJURY (Per person) $ XXXXXXX A HIRED AUTOS CA2651854(VA) B NON -OWNED AUTOS CA2651855 (OR) BODILY INJURY (Perac ident) $ XXXXXXX PROPERTY DAMAGE (Per aaident) $ XXXXXXX GARAGE LIABILITY 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 $ XXXXXXX AGGREGATE $ XXXXXXX $ XXXXXXX ❑ UMBRELLA XXXXXXX DEDUCTIBLE FORM $ XXXXXXX RETENTION $ C WORKERS COMPENSATION AND WC3599065 (AOS) 04/01/2005 04/01/2006 X ITIC STATUCRYJMI- I OTH- Ell A EMPLOYERS' LIABILITY WC3599067 ( CO ) E.L. EACH ACCIDENT E 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 B WC3599068 (OR) E.L. DISEASE -POLICY LIMIT $ 2000000 C WC3599066 WI/WC3599069 N OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS THE GENERAL LIABILITY POLICY IS SUBJECT TO A PRODUCTS -COMPLETED OPERATIONS AGGREGATE ONLY. NO GENERAL AGGREGATE APPLIES AS THE POLICY WILL RESPOND TO EACH AND EVERY OCCURRENCE WITH A LIMIT OF LIABILITY SHOWN. THE CITY OF FORT COLLINS AND THE CITY OF FORT COLLINS ENGINEERING DEPARTMENT ARE ADDITIONAL INSUREDS (EXCEPT ON WORKER'S COMP) AS RESPECTS OPERATIONS OF THE NAMED INSURED WHERE REQUIRED BY WRITTEN CONTRACT. RE: ASPHALT OVERLAY PROJECT 2005 CITY OF FORT COLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION ATTN: JAMES O'NEILL DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN PO BOX 580 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL FORT COLLINS CO 80522 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25-S (7/97) Forquestions ragerdinathiscertiticete,eontectthenunrherlistedinths'Protlues section above and epecity the clkntootle'LAFN001'. 0ACO DCORPORATiON19AA