HomeMy WebLinkAboutEXPRESS CONCRETE - INSURANCE CERTIFICATE (2)ACORD.M CERTIFICATE OF LIABILITY INSURANCE 0DATE (MMID
7/18108D/YYYY)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4821 Wheaton Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P O Box 270370 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURERA: United Fire & Cas.
Express Concrete, Inc. INSURER B:
PO Box 273209 --- ------
Fort Collins, CO 80527-3209 INSURER C'
INSURER D:
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 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
ADD'
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDDIYV
POLICY EXPIRATION
DATE MMIDDIYV
LIMITS
A
GENERAL LIABILITY
60079838
07/13/08
07/13/09
EACH OCCURRENCE
$1000000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE Fx� OCCUR
DAMAGE TO RENTED
PREMISES Pa occurr ,Ce
$100,000
MED EXP (Any one person)
$5 000
X PD Ded:500
PERSONAL & ADV INJURY
$1 000 000
GENERAL AGGREGATE
$2 000 000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGO
$2000000
POLICY X PRO
ECT LOC
A
AUTOMOBILE
LIABILITY
ANY AUTO
60079838
07/13/08
07/13/09
COMBINED SINGLELIMFr
(Ea accident)
$1,000,000
X
BODILYINJURY
(Perrperpen son)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON -OWNED AUTOS
X
BODILY accident)
(Per accitlenQ
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGO
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$
AGGREGATE
$
OCCUR El CLAIMS MADE
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
WC STATU- OTH-
LIMITSIQBY E
E.L. EACH ACCIDENT Is
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICEP/MEMBER EXCLUDED?
describePRO
E.L. DISEASEEAIf
$
EL,DISEASE -POLICYLIMIT
$
SPECIAL ISIO
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT) SPECIAL PROVISIONS
City of Fort Collins
215 Mason Street
Fort Collins, CO 80521
LO ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL I. DAYS WRITTEN
E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO $O SHALL
{E NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
r r V, 1 trmgtV 1 oc JZS 0 ACURD CORPORATION 1988
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.
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