HomeMy WebLinkAboutEXPRESS CONCRETE - INSURANCE CERTIFICATE (3)Client#: 35316
EXPCO
ACORD,M CERTIFICATE OF LIABILITY INSURANCE
DATE (MMID D/YYYY)
07/18/08
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
P O Box 270370
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins, CO 80527
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
Express Concrete, Inc.
PO Box 273209
INSURERA: United Fire & Cas.
INSURER B:
—
INSURER C:
Fort Collins, CO 80527-3209
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.
LTR
NSR1
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDD/YV
POLICY EXPIRATION
DATE MWDDNY1
LIMITS
A
GENERAL LIABILITY
60079838
07/13/08
07/13/09
EACHOCCURRENCE
$1 000,,000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE O OCCUR
DAMAGE TO RENTED
PREMISES (Ea occurrence)
$100,000
MED EXP (Any one person)
$ j 000
X PD Ded:500
PERSONAL &ADV INJURY
$1 000 000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGO
$2000000
POLICY X JECT LOC
A
AUTOMOBILE
LIABILITY
ANY AUTO
60079838
07/13/08
07/13/09
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY)
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUl'OS
HIRED AUTOS
NON -OWNED AUTOS
X
BODILYINJURY
accitlent)
(Perraccident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN [A ACC
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESSIUMBRELIA LIABILITY
OCCUR F—ICLAIMS MADE
EACH OCCURRENCE
$
AGGREGATE
$
$
DEDUCTIBLE
$
RETENf10N $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
WC STATU- GTH-
IMIT -
E.L. EACH ACCIDENT
$
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. DISEASE - EA EMPLOYE
$
OFFICERIMEMBER EXCLUDED?
If yes, describe under
E.L. DISEASE -POLICY LIMIT
$
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
The City of Fort Collins, its officers, agents and employees are named as
Additional Insureds on general liability and auto liability. The
insurance evidenced by this Certificate will not be cancelled or
materially altered, except after 10 days written notice has been mailed to
the City of Fort Collins.
City of Fort Collins
PO Box 580
Fort Collins, CO 80522
LD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
;E NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
-I or z ?FM4zUf8Z JZS 0 ACORD CORPORATION 1988
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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