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EXPRESS CONCRETE - INSURANCE CERTIFICATE (4)
Client#: 35316 EXPCO ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE 08120/080/vyvv) 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 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O Box 270370 Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC # INSURED Express Concrete, Inc. PO Box 273209 Fort Collins, CO 80527-3209 INSURERA: United Fire & Cas. — INSURER B: INSURER C: INSURERD' INSURER E: 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 LTR ADD' NSR TYPE OF INSURANCE POLICY NUMBER DATEYMMIDD/YYE POLIY EXPIRATION ATE MMIDDIYY) LIMITS A GENERAL LIABILITY 60079838 07/13/08 07/13/08 _ EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 51OCCUR CANCELLED PREMIGETOEENT[Dn $100000 MED EXP (Any one person) $$ 000 PERSONAL& ADV INJURY $1000000 X PDDed:500 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG s2,000,000 POLICY PRO LOC JECT A AUTOMOBILE LIABILITY ANY AUTO 60079838 07/13/08 CANCELLED 07/13/08 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AU U X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESWUMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE $ DEDUCTIBLE $ RETENTION _$ WORKERS COMPENSATION AND ---� ------ ---__ _ _ T1] STAIU-, rCTN- SI F EMPLOVERS'LIABILITY .L1MT ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below S E.L. DISEASE -POLICY LIMIT I $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS **All Policies Cancelled Effective 7/13/2008.** 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 (See Attached Descriptions) City of Fort Collins PO Box 580 Fort Collins, CO 80522 LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _3Q._ DAYS WRITTEN E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUUT-HORIZED REPRESENTATIVE y- T'�1.10� � �58�..1 .[. R..!'g WP"6r..3/G.rL �.�/�• ACORD 25 (2001108) 1 of 3 #M423530 JZS © ACORD 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. -.1--- 1-.1 , 4 of a SIV14430Su DESCRIPTIONS (Continued from Page 1) materially altered, except after 10 days written notice has been mailed to the City of Fort Collins. AMS 25.3 (2001/08) 3 of 3 #M423530