HomeMy WebLinkAbout128247 PIONEER SAND COMPANY INC - INSURANCE CERTIFICATE (17)ACORD,a
Acordia Mountain Nest
P 0 Box 39117
5755 Mark Dabling Blvd Ste 300
Colorado Springs CO 80949-9117
(719) 592-1177
Pioneer Sand Company, Inc.
Pioneer Landscaping Materials
P 0 Box 7650
Colorado Springs, CO 80933
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.
COMPANIES AFFORDING COVERAGE
COMPANY
A Zurich Commerc
COMPANY
B Pinnacol Assur
COMPANY
C. Lexington Insu
COMPANY
D
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVEFOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERMOR CONDITION OF ANY CONTRACTOR 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 POLICY EXPIRATION
LTR DATE (MMIDDIYY) DATE (MMIDD/YY) LIMITS
A GENERAL LIABILITY CPP3757937 9/01/03 9/01/04 GENERAL AGGREGATE $
2 000 000
X
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FX I OCCUR
OWNER'S & CONTRACTOR'S PROT
PRODUCTS-COMP/OP AGG
$ 2.000.000
PERSONAL & ADV INJURY
$ 1,000,000
EACH OCCURRENCE
$ 1,000,000
FIRE DAMAGE (Any one fire)
$ 300,000
MED EXP (Any one person)
$ 10,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
BAP3757938
CITI
9/01/03
SEp p 20
OF�� L;
9 04
�j
3
LLINS
ENT
COMBINED SINGLE LIMIT
f
1,000,000
X
BODILY INJURY
(Per person)
$
X
(Per accident)
$
X
PROPERTY DAMAGE
$
GARAGE LIABILITY
ANY AUTO
P1SY,AUTO
ONLY • EA ACCIDENT
$
OTHER THAN AUTO ONLY:
EACH ACCIDENT
$
AGGREGATE
S
A
EXCESSLIABILITY
X UMBRELLA FORM
OTHER THAN UMBRELLA FORM
AUC3757940
9/01/03
9/01/04
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 10,000,000
$
B
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY
THE PROPRIETOR/ X INCL
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL
4018785(COLORADO)
2/01/03
2/01104
X WC STATU- OTH-
T V IA4 R
EL EACH ACCIDENT
$ 500,000
EL DISEASE -POLICY LIMIT
$ 500,000
EL DISEASE -EA EMPLOYEE
$ 500,000
OTHER
C Property & Inland Marine 7475564 9/01/03 9/01/04 5,000,000 Per Occurrence
C Leased/Rented Equipment 7475564 9/01/03 9101/04 600,000 Per Occurrence
C Motor Car o Le al Ill' . 7475564 9/01/03 9/01/04 100,000 Legal Liability
DESCRIPTION OF OPE!ATIONSA•C ATIONSIYEHICLES/SPECIAL ITEMS
RE: Bid #5148 Infield Sail Mix
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of Ft. Collins EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
P. 0. Box 580 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Ft. Col I ins, CO 80522-0580 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF_A "IND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
Sue Ellen Puerta 100520
CERTIFICATE: 182/001/ 00176