HomeMy WebLinkAbout120116 BESTWAY CONCRETE CO - INSURANCE CERTIFICATErlrnnffi 78517
ACORN6OB CERTIFICATE OF LIABILITY INSURANCE
DATE DNYYY)
02/2/08
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Ins Inc
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P O Box 578
HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR
4687 W 18th Street
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Greeley CO 80632
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER Travelers Insurance Company
Bestway Concrete Company
INSURER a Gre at American Excess Liability Div
301 Centennial
INSURER PlnnacolAssurance
Milliken CO 80543 3222
54
INSURER D
NSURER E
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
POLICY EFFECTIVE
DATE MM DD
POLICY EXPIRATION
TE EXPIRATION
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE Fx] OCCUR
630956OA36STIL08
03/01/08
03/01/09
EACH OCCURRENCE
$1000000
DAMAREMGE TO RENTED
$100OOO
$5 000
MED EXP (Any one person)
PERSONAL &ADV INJURY
$1000000
GENERAL AGGREGATE
$2 OOO OOO
GEN L AGGREGATE LIMIT APPLIES PER
PRO LOC
POLICY JE
PRODUCTS COMP/OP AGG
s2,000,000
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON OWNED AUTOS
8109560A365TILOB
03/01/08
03/01/09
COMBINED SINGLE LIMIT
(Ea accident)
$1 OOOOOO
BODILY INJURY
(Per parson)
$
X
BODILY INJURY
(Per accdent)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTOONLY EAACCIDENT
$
OTHEHAN EA ACC
AUTO ON
AUTO ONLY qGG
$
$
B
EXCESS/UMBRELLA LIABILITY
X1 OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $ O
TUU5680546
03/01/08
03/01/09
EACH OCCURRENCE
$2000000
AGGREGATE
s2.000.000
$
$
C
WORKERS COMPENSATION AND
LIABILITY
PROPRIETOWPARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes describeunder
SPECIAL PROVISIONS below
4026925
03/01/08
03/01/09
X WORSTATU IEMPLOYERS
LIMANY
E L EACH ACCIDENT
$500000
EL DISEASE EA EMPLOYEE
$SOO OOO
EL DISEASE POLICY LIMIT 1$500.000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
CITY OF FORT COLLINS
P O BOX 580
FORT COLLINS CO 80522
I ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
IEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL -1D_ DAYS WRITTEN
TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL
NO OBLIGATION OR LNSILITY OF ANY KIND UPON THE INSURER RS AGENTS OR
ACORD 25 (2001/08) 1 of 2 i1Sd07267111,11 69
FIMI O ACORD CORPORATION 198E
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 (2001/081 9 . f 9 HQAA71 R71AAAn71e0