HomeMy WebLinkAboutVOGEL CONCRETE - INSURANCE CERTIFICATE (2)ACORD- CERTIFICATE OF LIABILITY INSURANCE OP ID KH DATE(MM/DDIYYYY)
VOGEL-1 07 Ol 08
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
LBN Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
4848 Thompson Pkwy ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Johnstown CO 80534
Phone:970-635-9400 Fax:970-635-9401 INSURERS AFFORDING COVERAGE NAIC#
INSURER A:
INSURER B:
Voel Concrete, Inc. INSURER C:
131gg3 Blue Spruce Drive #B INSURER D:
Fort Collins CO 80524-2394
COVERAGES
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 1407 ___-- POLICY EFFECTIVE POLICY EXPIRATION -------------------------
LTR ))NSR TYPE OF INSURANCE POLICY NUMBER DATE MWDD/YV DATE MM/DDlYV LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$
COMMERCIAL GENERAL LIABILITY
N/A
DAMAGE TORENTED
(Ea occurence)
$
CLAIMS MADE }( OCCUR
MED EXP (Any one person)
$
PERSONAL 8 ADV INJURY
$
GENERAL AGGREGATE
$
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$
-- PRO.
POLICY JECT LOD
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
ANY AUTO
N/A
(Ea accident)
$
BODILY INJURY
ALL OWNED AUTOS
SCHEDULED AUTOS
(Per person)
$
BODILY INJURY
HIRED AUTOS
NON -OW NED AUTOS
(Pet accident)
$
PROPERTY DAMAGE
$
(Per accident)
GARAGE LIABILITY
AUTOONLV-EAACCIDENT
$
ANY AUTO
N/A
EA ACC
$
OTHER THAN
--
$
AUTO ONLY: ASS
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
N/A
AGGREGATE
$
$
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION AND
X TORYLIMITS ER OTH
A
EMPLOYERS'LIABILITV
4102132
07/01/08
07/01/09
_ -- —_--
EACH ACCIDENT
$100000
ANY PROPRIETOR/PARTNER/EXECUTIVE
_EL.
--.__.___.._..._... _--
OFFICERIMEMBER EXCLUDED?
E.L. DISEASE - EA EMPLOYEE
$ 100000
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$500000
OTHER
N/A
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
FTCOLLI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
City of Ft. Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Attn: James B. O'Neill
P.O. Box 580 REPRESENTATIVES.
Ft. Collins, CO 80522-0580 AUT 1RpYRESEBfiIVE'�An uI• d/if iL1
WQN901[7e1111iPldfGSkI
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.