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THOUTT BROS CONCRETE - INSURANCE CERTIFICATE
ACORD CERTIFICATE OF LIABILITY INSURANCE CST MS DATE (MM/DDIYYYY) THOUT-1 03 30 05 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CRS Insurance Brokerage HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 6600 E . Hampden Ave., 2nd Flr. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Denver CO 80224 Phone:303-996-7800 Fax:303-757-7719 INSURED Thoutt Bros Concrete Contractors, Inc. 5460 Tennyson Street Denver CO 80212 I VYcR kjco INSURERS AFFORDING COVERAGE NAIC # INSURERA: Zurich Insurance 165? INSURER B' Fireman' s Fund Ins. Co. INSURER C: American International Coe. INSURER D: American Guarantee a Liability 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. "K LTRINSRE KOLI'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD/YY POLICY EXPIRATION DATE MMIDD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 ,QQQ ,QQQ A X X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X� OCCUR GL003758063 04/01/05 04/01/06 PREMISES (Ea occurence) s300,000 MED EXP (Any one person) 8 10,000 X Incl XCU PERSONAL & ADV INJURY $ 1 , 000 , 000 GENERAL AGGREGATE $2 000,000 GEN'L AGGREGATE LIMI: APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO- JECT LOC D AUTOMOBILE LIABILITY ANYAUTO RAP3758090 04/01/05 04/01/06 (EaCOMBINED SINGLE LIMIT CO accident) $ 1r000 r QQQ X ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ D D HIREDAUTOS NON-OWNEDAUTOS X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGG $ $ C EXCESSIUMBRELLA LIABILITY X OCCUR F-ICLAIMSMADE BE2911606 04/01/05 04/01/06 EACH OCCURRENCE $ 1,000,000 AGGREGATE $1,000,000 DEDUCTIBLE X RETENTION $10 000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TORYLIMITS ER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below —-'�'-"'— E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ OTHER B Equipment Floater MZ198472373 04/01/05 04/01/06 Deduct $1,000 B Rented Equipment $300 000 PER ITEM 04/01/05 04/01/06 ACV DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS City of Fort Collins is named as Additional Insured on the General Liability with respect to operations of the named insured for the certificate holder. CTYFCOL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN City of Fort Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL Attn : Purchasing 215 N. Mason IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Ft. Collins CO 80524 REPRESENTATIVES. ACORD 26 (2001/08) © ACORD