HomeMy WebLinkAbout195476 ADVANCED CONCRETE - INSURANCE CERTIFICATEACORD_ CERTIFICATE OF LIABILITY INSURANCE OP ID B
DATE (MM )
ADVAN-7
01 31 1/0606
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Six & Geving/Denver Office
225 Union Blvd. #575
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Lakewood CO 80228
Phone:720-962-0930 Fax:720-962-0942
INSURERS AFFORDING COVERAGE
NAIC#
INSURED
INSURER A: EMC Insurance Companies
Advanced Concrete Construction
Inc.
INSURER B: Pinnacol Assurance
INSURER C:
2902 w Mansfield Ave
Englewood CO 80110
INSURER D:
INSURER E:
ruov
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
�01
INSRE
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM/DDIYY
POLICY EXPIRATION
DATE MWD
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1 , 000 , 000
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FX� OCCUR
2X4449407
01/01/06
01/01/07
PREMISES Eaoccurence
$50 000
MED EXP (Any one person)
$5 , 00 0
PERSONAL & ADV INJURY
$1,000 000
a8 PSI POLICY TW= AND
GENERAL AGGREGATE
s 2 000, 000
CONDITIONS
GEN'L AGGREGATE LIMIT APPLIES PER
X POLICY j�T LOC
PRODUCTS-COMP/OP AGG
$2,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
2X4449407
01/01/06
01/01/07
COMBINED
(ED&cccdenl)lNGLELIMIT
$1,000,000
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accidwt)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
A
EXCESSIUMBRELLA LIABILITY
X OCCUR I—ICLAIMSMADE
2X4449407
01/01/06
01/01/07
EACH OCCURRENCE
$2,000,000
AGGREGATE
$2,000,000
s
DEDUCTIBLE
$
X RETENTION $10 000
$
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNER/EXECUT(VE
OFFICERIMEMBER EXCLUDED?
undw
SPECIAL
SPECIAL PROVISIONS below
PROVISIONS
4077192
02/01/06
02/01/07
X I TORY LIMITS ER
E.L. EACH ACCIDENT
$100,000
E.L. DISEASE - EA EMPLOYE
$ ZOO 000
E.L. DISEASE - POLICY LIMIT
$ 5 0 0 , 000
OTHER
A
Leased or Rented
2X4449407
01/01/06
01/01/07
Limit $100,000
Ecruipment
Ded $500
DESCRIPTION OF OPERATIONS! LOCATIONS! VEHICLES! EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS
The Certificate Holder, City Of Ft. Collins, is named as an additional
insured, except for workers compensation. Project: Trail Cherry & College
Avenue
City of Ft. Collins
215 N. Mason Street
Ft. Collins CO 80522-0580
CFTC- 01 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAT101
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY K020 UPON THE INSURRE' ITS AGENTS OR
REPRESENTATIVES. y _,
(2001108)