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Home My WebLink AboutLAFARGE WEST INC - INSURANCE CERTIFICATEI I§ (la DATE(MM/DD/YYYY) A CORD. i 05/13/2008 Paopucea APRODUCER Risk Services Central Inc THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY fka ADD Risk Services Inc of PA AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS One Liberty Place CERTIFICATE DOES NOT AMEND EXTEND OR ALTER THE 1650 Market Street COVERAGE AFFORDED BY THE POLICIES BELOW suite 1000 PMladel pphTa PA 19103 USA INSURERS AFFORDING COVERAGE NAIC p PHONE 866 283-7122 FAx 847 953 5390 INSURED INSURER American Home Assurance Co 19380 ,. Lafarge west Inc 1800 North raft Hill Road Fort Collins CO 80521 USA L a e 9 INSURER National union Fire Ins Co of Pittsburgh 19445 INSURER Insurance Company of the state of PA 19429 INSURER Illinois National Insurance Co 23817 d S INSURER 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 ADEPI INSR TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTIVEPOLICY DATE(MM\DD\YY) EXPIRATION pATE(MM\DD\YV) LIMITS A ERAL LIABILITY 1595365 (VA/CM) 07/01/07 07/01/08 EACH OCCURRENCE $2 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $500 000 X CLAIMSMADE ❑ OCCUR PREMISES(E re ) Y mPnm PERSONAL& ADV INJURY $2 000 000 b � 1. N GENERAL AGGREGATE $2 000 OOO GENLAGGREGATE LIMIT APPLIES PER ❑X POLICY ❑ PRO - POLICY LOU JECT PRODUCTS COMP/OP AGO $2 000 000 A A B A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON OWNED AUTOS 1606931 1606932 (MA) 1606933 (OR) 1606934 (VA) 07/01/07 07/01/07 07/01/07 07/01/07 07/01/08 07/01/08 07/01/08 07/01/08 COMBINED SINGLE LIMIT IF . d O $2 000 000 U X BODILY INJURY I Per p rn) BODILY INJURY (P .0.) PROPERTY DAMAGE (Per dem) GARAGE LIABILITY AUTOONLY EAACCIDENT ANY AUTO OTHERTHAN EA ACC AUTOONLY AGO EXCESS /UMBRELLA LIABILITY EACH OCCURRENCE ❑ OCCUR ❑ CLAIMS MADE AGGREGATE BDEDUCTIBLE RETENTION A D A D C WORKERRS LIABILITY NAND EMPLOYERS EDIBILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICEREMBER EXCLUDED /M I�fbW dwcrLe wrier SPECIAL PROVISIONS OTHER A05 1616289 (CA) 1616291 (FL) 1616291 (LA etc) 1616293 (MI) 1616293 (N]) 07/01/07 07/01/07 07/O1/07 07/01/07 07/Ol/07 07/01/08 07/01/08 07/01/08 07/01/08 D7/D1/DB X WC STATU OTH E L EACH ACCIDENT $2 000 000 EL DISEASE E-A EMPLOYEE E2 OOO OOO _ EL DISEASE POLICY LIMIT $2 000 DOO DESCRIPTION OF OPERATIONSVOCATIONS/VEHICLESMXCLUSIONS ADDED BY ENDORSEMENTSPECIAL PROVISIONS CITY OF FORT COLLINS PURCHASING DIVISION Additional Insured (except on worker s Comp) as respects to operations of the named insured where required by written contract waiver of subrogation is granted in favor of certificate holder as requT red by written contract but limited to the operations of the insured under said contract and Rn is CITY OF FORT COLLINS PURCHASING DIVISION SHOULDANYOP THFAR'VE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 21S N MASON ST P O BOX $BO DATE THEREOP THE ISSUING INSURER WILL ENDEAVOR TO MAIL FORT COLLINS CO 80522 USA 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT im BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITYMINIM OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE ..® /7F ®rpm •YIGr� .yllyfJ G�Aw6 ��_i Attachment to ACORD Certificate for Lafarge west Inc The terms conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the coverage afforded by the insurer(s) This attachment does not contain all terms conditions coverages or exclusions contained in the policy INSURED Lafarge West Inc 1800 North Taft Hill Road Fort Collins CO 80521 USA ADDITIONAL POLICIES If a policy below does n INSURER INSURER INSURER INSURER INSURER of include limit information refer to the corresponding policy on the ACORD certificate form for policy limits INSIF LTR ADD INSRD TYPE OF INSURANCE POLICY NUMBER POLICY DESCRIPTION POLICY EFFECTIVE DATE POLICY EXPIRATION DATE LIMITS WORKERS COMPENSATION D 1616294 (OR) 07/01/07 07/01/08 C 1616295 (WI) 07/01/07 07/01/08 DESCRIPTION OF OPERATIONS/LOCATIONS EHICLES/EXCLUSIONS ADDED BY ENDORSEMENLSPECIAL PROVISIONS always subject to the policy terms conditions and exclusions Certificate No 570028401560