HomeMy WebLinkAboutLAFARGE WEST - INSURANCE CERTIFICATE (11)ACORDw CERTIFICATE OF LIABILITY INSURANCE 04/O1/2006
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PRODUCER
Lockton Companies
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 THE POLICIES Bf&QW�
INSURERS AFFORDING COVERAGE
INSURED LAFARGE WEST INC
1060502 CONCRETEIAGGREGATE
1800 N. TAFT HILL RD.
FORT COLLINS CO 80525
INSURER A: AMERI AN HOME ASSURANCE CO.
INSURERS: NATIONAL UNION FIRE INS CO
INSURER C INS CO. STATE OF PA
INSURER 0,
rnvvRArFs I.AF Onl FIC
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
LTjR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE IMWDDfYYIT
POLICY EXPIRATION
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
X CLAIMS MADE 0 OCCUR
GL3314756
04/01/2005
04/01/2006
EACH OCCURRENCE
S 2,000,000
FIRE DAMAGE (Any one fire
$ 500,000
MED EXP (Any oneperson)
$ 5,000
PERSONAL 8 ADV INJURY
$ 2 000 000
GENERAL AGGREGATE
$ See Below
GEN'L AGGREGATE LIMIT APPLIES
P LI Y JELQT
PER:
L
PRODUCTS - COMP/OP AGG
2,000.000
A
A
A
A
B
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
CA2651851 (AOS)
CA2651853 (MA)
CA2651852(TX)
CA2651854 (VA)
CA2651855 (OR)
04/01/2005
04/01/2006
COMBINED SINGLE LIMIT
(Ea accident)
$ 2,000,000
X
BODILY INJURY
(Per person)
$ XXXXXXX
BODILY INJURY
(Per accident)
E XXXXXXX
PROPERTY DAMAGE
(Per accident)
S XXXXXXX
GARAGE LIABILITY
ANYAUTO
NOT APPLICABLE
AUTO ONLY - EA ACCIDENT
$ XXXXXXX
OTHER THAN EA ACC
AUTO ONLY: AGG
XXXXXXX
S XXXXXXX
EXCESS LIABILITY
OCCUR CLAIMS MADE
❑ uMB�u.a
DEDUCTIBLE FORM
RETENTION $
NOT APPLICABLE
EACH OCCURRENCE
$ XXXXXXX
AGGREGATE
$ XXXXXXX
XXXXXXX
S XXXXXXX
S XXXXXXX
C
A
B
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
WC3599065(AIDS)
WC3599067 (CO)
WC3599068 (OR)
WC3599066 WI /WC3599069 IN
04/01/2005
IE.L.
04/01/2006
WCSTATU- OTH-
}( IO LIMITS ER
E.L. EACH ACCIDENT
$ 2,000,000
E.L. DISEASE - EA EMPLOYEE
$ 2,000,000
DISEASE - POLICY LIMIT
$ 20()0,000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECUIL PROVISIONS
***THE AGGREGATE LIMIT IS: NIL. 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. CERTIFICATE OF INSURANCE PERTAINS TO ANY PARTICULAR LOCATION/CONTRACT/ITEM/VEHICLE OR IF THERE ARE ANY
SPECIAL REQUIRMENTS. CITY OF FORT COLLINS IS ADDITIONAL INSURED (EXCEPT ON WORKER'S COMP) AS RESPECTS OPERATIONS
OF THE NAMED INSURED WHERE REQUIRED BY WRITTEN CONTRACT. RE. JOB: CITY OF FORT COLLINS LIGHT & POWER 2006.
2491751 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 DAYS WRITTEN
ATTN: JOHN STEPHEN
PO BOX 580 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,SUT FAILURE TO DO SO SHALL
FORT COLLINS CO 80522-0580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORn 25 S r71971 For gbesllona mWeding this certlneats, contact the number listed in the'Producee section above and Specify the client code'LAFNnet'. ® ACORD CbRPORATION 1988