HomeMy WebLinkAbout128247 PIONEER SAND COMPANY INC - INSURANCE CERTIFICATE (15)ACORD
IYY
PRODUOER ': .::. ... .... ..... ..:.
Acordia Mountain West
P 0 Box 39117
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.
5755 Mark Dabling Blvd Ste 300
COMPANIES AFFORDING COVERAGE
Colorado Springs CO 80949-9117
COMPANY
(719) 592-1177
A Zurich American Insurance Company
INSURED
COMPANY
Pioneer Sand Company, Inc.
B Pinnacol Assurance
Pioneer Landscaping Materials
COMPANY
P 0 Box 7650
Ci Lexington Insurance
Colorado Springs, CO 80933
COMPANY
D
V...... . .10
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED,NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANYCONTRACT OR OTHER DOCUMENTWITH RESPECT TO WHICHTHIS
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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MMR)D/YY)
=EXP,1RATIONLTA
LIMITS
A
GENERALLIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 5-1 OCCUR
OWNER'S & CONTRACTOR'S PROT
GL03757932-01
9l01/04
9/01/05
GENERAL AGGREGATE
$ 2,000,000
X
PRODUCTS-COMP/OP AGG
$ 2,000,000
PERSONAL & ADV INJURY
$ 1,000,000
EACH OCCURRENCE
f 1,000,000
FIRE DAMAGE (Any one fire)
$ 300,000
MED EXP (Any one person)
$ 10,000
A
AUTOMOBILE
LIABLITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
BAP3757938-01
9/01/04
9/01/05
COMBINED SINGLE LIMIT
$
1,000,000
X
BODILY INJURY
(Per person)
$
HIRED AUTOS
NON -OWNED AUTOS
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
OTHER THAN AUTO ONLY:
EACH ACCIDENT
It
AGGREGATE
$
A
EXCESS LIABILITY
X UMBRELLA FORM
OTHER THAN UMBRELLA FORM
AUC3757940(PRIMARY UMB)
9/01/03
11/01/04
EACH OCCURRENCE
$ 5/000/000
AGGREGATE
$ 5,000,000
$
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITYER
4018785(COLORAD0)
2101/04
2/01/05
WTA1U- OTH•
X C S
EL EACH ACCIDENT
S 500,000
THE PROPRIETOR/ INCL
PARTNERS/EXECUTIVE X
OFFICERS ARE: EXCL
EL DISEASE -POLICY LIMIT
$ 500,000
EL DISEASE -EA EMPLOYEE
$ 500,000
OTHER
C Property/Inland Marine 9182535
9/01/04 9/01/05 5,000,000 Per Occurrence
C Leased/Rented Equipment 9182535
9/01/04 9/01/05 600,000 Per Occurrence
C Motor Caro La al Liab. 9182535
DESCRIPTION OF OPERATIONSLOCATIONS/VEHICLESISPECIAL ITEMS
9/01/04 9/01/05 100,000 Le al Liabllit
RE: Bid #5148 Infield Soil Mix
L
COW .................................................::::.:::::::::::::.:::::::.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of Ft. Collins
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WLL ENDEAVOR TO MAIL
P. 0. Box 580
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Ft. Collins, CO 80522-0580
BUT FALURE TO MAL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
:,.;.;:..:..::.......
C371 R.2.:5.. iJ�s .::::.3AG34Gti)hKTIQi.t8o:
AUTHORIZED REPRESENTATIVE
Sue Ellen Pusrta 100520
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CERTIFICATE: 187/001/ 00176