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Home My WebLink About108423 VOGEL CONCRETE - INSURANCE CERTIFICATE (3)CERTIFICATE OF LIABILITY INSURANCE American Family Insurance Company ❑ American Family Mutual Insurance Company if selection box is not checked. 6000 American Pky Madison, Wisconsin 53783-0001 Agent's Name, Address and Phone Number (Agt./Dist.) Insured's Name and Address: HAROLD F. LEE (127/305) VOGEL CONCRETE INC 2950 SO JAMAICA CT STE 100 1313 BLUE SPRUCE DRIVE B AURORA, CO 80014 FT COLLINS CO 80524 303-695-1040 This certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. Thin rnrti6ratn rime nM amanrl aHanrl nr altar tho rnvarana nffnrdad by tha nnlirias listed below. COVERAGE$ This is to certify that 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. POLICY TYPE TYPE OF INSURANCE POLICY NUMBER LIMITS OF LIABILITY Effective Expiration MO,Da ,Yr Mo,Da ,Yr Homeowners/ Bodily Injury and Property Damage Mobilehomeowners Liability Each Occurrence Boatowners Liability Bodily Injury and Property Damage Each Occurrence Personal Umbrella Liability Bodily Injury and Property Damage Each Occurrence Farm/Ranch Liability Farm & Personal Liability Each Occurrence Farm Employer's Liability Each Occurrence Statutory Workers Compensation and Each Accident Employers Liability + Disease - Each Employee Disease - Policy Limit General Liability General Aggregate $ 2,000,000 ® Commercial General 05-X60979-47 1/1/2005 1/1/2006 Products - Completed Operations Aggregate $ 2,000,000 Liability (occurrence) Personal and Advertising Injury $ 1,000,000 ❑ Each Occurrence $ 1,000,000 ❑ Damage to Premises Rented to You $ 100,000 Medical Expense (Any One Person $ 5,000 Businessowners Liability Each Occurrence ++ Aggregate + + Liquor Liability Common Cause Limit Aggregate Limit Automobile Liability Bodily Injury - Each Person $ 1,000,000 ❑ Any Auto Bodily Injury - Each Accident $ 1,000,000 ® All Owned Autos 05-X60979-46 1/1/2005 1/1/2006 Property Damage $ 1,000,000 ❑ Scheduled Autos Bodily Injury & Property Damage Combined ® Hired Autos ® Nonowned Autos Excess Liability ® Commercial Blanket Excess Each Occurrence/Aggregate Other (Miscellaneous Coverages) DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS +The individual or partners shown as Insured '•• elected to be ADDITIONAL INSUREDS: CITY OF FT COLLINS covered as employees under this policy. ++ Products -Completed Operations aggregate is equal to each occurrence limit and is included in policy aggregate. CERTIFICATE HOLDER'S NAME AND ADDRESS CANCELLATION ® Should any of the above described policies be canceled before the CITY OF FT COLLINS expiration date thereof, the company will endeavor to mail'( 30 days) written PURCHASINGnotice to the Certificate Holder named, but failure to mail such notice shall PO BOX 580INS impose no obligation or liability of any kind upon the company, its agents or FT COX CO 80522 representatives. *10 days unless different number of days shown. ❑ This certifies coverage on the date of issue only. The above described policies are subject to cancellation in conformity with their terms and by the laws of the state of issue. DATE ISSUED ALIT ORIZED REPRESENTATIVE 05/24/2005 U-201 Ed. 05100 ORIGINAL - Certificate Holder, COPIES to Services, Insured, Agent ' V J1OCK NO. Motib ACORDn CERTIFICATE OF LIABILITY INSURANCE 5DATE 124/05ODnrrYl PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Insurance Inc 4821 Wheaton Drive ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O Box 270370 Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC # INSURED Vogel Concrete Inc. 1313 Blue Spruce Dr #B Fort Collins, CO 80524 INSURERA: Plnnacol Assurance INSURER B: INSURER C: INSURER D: INSURER E: CAVFRAGFS 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 DALTEYMWDD/YYE POLICY DATE MWDD/YY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDPREMISE fEa occurrence) $ CLAIMS MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ PRO- 17 POLICY ElJECT DLOG AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ A WORKERS COMPENSATION AND 2086850 07/01/04 07101/05 C SLIMIT OTH- TATUjI XT1W0I 1 EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $100,000 E.L. DISEASE - EA EMPLOYEd $100,000 OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT 1 $500,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS City of Ft Collins Purchasing Dept Attn: John Steven PO Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL An DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER N TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGA-00N OR LIABIUTY Y KIND IrON THE INSURER ITS AGENTS OR ACORD 25 (2001108) 1 of 2 #S315686/M285322 /-) /1r 1 "sikD -4ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25S (2001108) 2 of 2 #S315686/M285322