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Home My WebLink AboutLAFARGE WEST - INSURANCE CERTIFICATE (12)ACORa CERTIFICATE OF LIABILITY INSURANCE o4/ol/2oo7 03/23 zoo PRODUCER LocMon Companies Pa 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 B THE IFS RFI OW. INSURERS AFFORDING COVERAGE INSURED LAFARGE WEST INC 1060502 CONCRETEIAGGREGATE 1800 N. TAFT HILL RD. FORT COLLINS CO 80525 I INSURER A: AMERICAN HOME ASSURANCE CO. INSURER B: NATIONAL UNION FIRE INS C INSURER INS CO. S ATE OF PA �NSURERILLINOIS NATIONAL INS CO. I INSURER In rnvcwer_cc I .AFN 00I FK 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DDIY POLICY EXPIRATION DATE M D/Y LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY xjCLAIMS MADE 0 OCCUR GL3919992 04/01/2006 04/01/2007 EACH OCCURRENCE $ 2,000,134010 FIRE DAMAGE (Any one fire $ 500,000 MED EXP IAnj we erson $ 5 000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ See Below GEN'L AGGREGATE LIMIT APPLIES PER: Fl POLVCV JEPROC LOC 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 CA3802975 (AOS) CA3802976(MA) CA3902979 (TX) CA3803458(VA) CA3802977(OR) 04/01/2006 04/01/2007 (Ea accideent) ED SINGLE LIMIT $ 2,000,000 X BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident) $ XXXXXXX PROPERTY DAMAGE (Per accident) $ XXXXXXX GARAGE LIABILITY ANY AUTO NOT APPLICABLE AUTO ONLY - EA ACCIDENT $ XXXXXXX OTHER THAN EA Arc AUTO ONLY: AGG s XXXXXXX $ XXXXXXX EXCESS LIABILITY OCCUR CLAIMS MADE UMBRELLA DEDUCTIBLE FORM RETENTION $ NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX AGGREGATE $ XXXXXXX $ XXXXXXX XXXXXXX $ XXXXXXX (' B C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC4784594 (AOS) WC4785228 (OR) WC4785861 (WI)/WC4785277 (NJ) O4/Ol/2006 O4/Ol/2007 OTH- X WCSTATU- ER E.L. EACH ACCIDENT S 2 000 OOO E.L. DISEASE - EA EMPLOYEE $ 2 000 OW E.L. DISEASE - POLICY LIMIT $ 2 000 OW D D D OTHER WORKERS COMPENSATION WC4785225(FL) WC4785862 (MI) WC4785226 (LA, ND, OH, WA, WV, T Y) DESCRIPTION OF OPERATIONS/LGCATIONSNEHK:LESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL 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/VEI-ICLE 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 COLD NS LIGHT & POWER 2006. rcwnctt^eTc unt new I I ...n,.,sr n,¢rr.. .Krroor,rr:..rr,. reMtrcl I ennu 2491751 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF FORT COLLINS ATTN: JOHN STEPHEN DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _ 0 DAYS WRITTEN PO BOX 580 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT 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 ACORD 25-S (7/97) Foryw.noesr.exdiayml.oertrcir*m,�tKthe n ae.11. Iom*'Produwr's«eoawo.eand sp«lfytn.client o eTAFNoot'. 0ACORDCbRPORATION1988 ACORQN CERTIFICATE OF LIABILITY INSURANCE o4ioli2oo7 o iz3 zoo PRODUCER Lockton Companies P THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 444 W. 47th Street, Suite 900 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Kansas City Mo 64112-1906 ALTER THE COVERAGE AFFORDED B THE IES BELOW- (816) 960-9000 INSURERS AFFORDING COVERAGE INSURED 1060502 LAFARGE WEST, INC. NORTHERN PAVING INSURER A: AMERICAN HOME ASSURANCE CO. INSURER B: NATIONAL UNION FIRE INS CO INSURER C : INS CO. STATE OF PA 1 BD0 N. TAFT HILL ROAD FORT COLLINS CO 80521 sugEg D, ILLINOIS NATIONAL INS. CO. COVFRAGFR T.AFNOOI FK 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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD/Y POLICY EXPIRATION DATE MAW LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 FIRE DAMAGE (AnY one fire $ 500 000 A X COMMERCIAL GENERAL LIABILITY X CLAIMS MADE OCCUR GL3919992 04/01/2006 04/01/2007 MED EXP (Any oneperson) $ 5 000 PERSONAL & ADV INJURY $ 2 000 000 GENERAL AGGREGATE $ See Below GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY O- JPEECT LOG A AUTOMOBILE LIABILITY ANY AUTO CA3802975 (AOS) 04/01/2006 04/01/2007 COMBINED (Ea accident) SINGLE LIMIT $ 2 000,000 X BODILY INJURY (Per person) $ XXXXXXX A A ALLOWNEDAUTOS SCHEDULED AUTOS CA3802976(MA) CA3802978(TX) BODILY INJURY (Per accident) $ XXXXXXX A B HIREDAUTOS NON -OWNED AUTOS CA3803458(VA) CA3802977(OR) PROPERTY DAMAGE (Per accident) $ XXXXXXX GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ XXXXXXX OTHER THAN EA Ac $ XXXXXXX ANY AUTO NOT APPLICABLE $ XXXXXXX AUTO ONLY: AGG EXCESS LIABILITY OCCUR CLAIMS MADE NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX AGGREGATE $ XXXXXXX $ XXXXXXX UMBRELLA XXXXXXX DEDUCTIBLE FORM $ XXXXXXX RETENTION $ C WORKERS COMPENSATION AND WC4784594 (AOS) 04/01/2006 04/01/2007 - OTH- X WRY LIMITS B EMPLOYERS' LIABILITY WC4785228 (OR) E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE$ 2000000 C WC4785861(WI)/WC4785277(N]) E.L. DISEASE - POLICY LIMIT $ 2,000,000 D OTHER WC4785225(FL) D WORKERS COMPENSATION WC4785862(MI) D WC4785226 (LA, ND, OR, WA, WV, ) DESCRIPTION OF OPERATIONSILOCATKINSNEHWLES/EXCLUSK)NS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ***THE AGGREGATE LJM1T 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. THE CITY OF FORT COLLINS AND THE CITY OF FORT COLLINS ENGINEERING DEPARTMENT ARE ADDITIONAL INSUREDS (EXCEPT ON WORKER'S COMP) AS RESPECTS OPERATIONS OF THE NAMED INSURED WHERE REQUIRED BY WRITTEN CONTRACT. RE: ASPHALT OVERLAY PROJECT 2005 CFRncIr.ATF RnI nFR I I AnnITInuAI INR11RFn• INCIIRFR I FTTFR- f AN( FI I ATInN 2257039 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPMATKM CITY OF FORT COLLINS ATTN: JAMES O'NEILL DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3_ DAYS WRITTEN PO BOX 590 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL FORT COLLINS CO 80522 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD25-S(7197) Forts +tim r.awingthim nlnral.,..r th.n.mn.rHOW Infl.'Pr.au ..mwe .n,,,*,Ra . Itrm.m.M. 'I.AFNOor. C ACORD COAPORATION 1988