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HomeMy WebLinkAboutROBINSON CONCRETE INC - INSURANCE CERTIFICATEACORD, CERTIFICATE OF LIABILITY INSURANCE REVISED DATE 08/25/2008' PRODUCER Serial # 108611 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MACHANN INSURANCE AGENCY 11160 NO. HURON, STE. 36 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. NORTHGLENN, CO 80234 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: STATE NATIONAL INSURANCE CO. CANC[=LLfD ROBINSON CONCRETE, INC. INSURER B: 16522 KEYSTONE BLVD., #N INSURER C: PARKER, CO 80134 INSURER D: 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 POLICES 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•L NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE (MMIDDNYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000. A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FX-1 OCCUR X NO RESIDENTIAL OR CSP0070105 2/1/08 8/31/08 PFEM ESDE o Tcmenc $ 100 000. MED EXP (Any oneperson) $ 5,000. PERSONAL & ADV INJURY $ 1,000,000. MULTI-FAM.EXCLUSIO GENERAL AGGREGATE $ 2000000. CANCELLED GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ 2000000. POLICY MPE LOC AUTOMOBILE X LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ A ALL OWNED AUTOS SCHEDULED AUTOS CSP0070105 2/1/08 8/31/08 BODILY INJURY (Per accident) $ HIRED AUTOS NON OWNED AUTOS CANCI_LI I:-.0 PROPERTY $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER EA ACC $ ANY AUTO $ ONLY AUTOONLV: AGG EXCESSIUMBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE 5 AGGREGATE $ I Is DEDUCTIBLE Is RETENTION $ WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY WW TORYTAMITS ER EL EACH ACCIDENT $ ANY PROPRIETOR/PARTNEPJEXECUTIVE EL DISEASE - EA EMPLOYEE $ OFFICER/MEMBER EXCLUDED? If yes, describe under EL DISEASE - POLICY LIMIT $ SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CITY OF FT. COLLINS IS AN ADDITIONAL INSURED PER CIMI CG 21 9 05 AND CIMI CIS 25 9 05 AS DEFINED WITH RESPECT TO GENERAL LIABILITY. PRIMARY/NONCONTRIBUTORY LANGUAGE IS CONTAINED IN THE ENDORSEMENT. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF FT. COLLINS DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN P.O. BOX 580 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL FT. COLLINS, CO 80532 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001/08) © ACORD CORPORATION 1988