HomeMy WebLinkAbout102511 LAFARGE NORTHERN INC - INSURANCE CERTIFICATE (5)ACORD. CERTIFICATE OF LIABILITY INSURANCE GATE
06106/2008Y)
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AOD Risk services Central Inc
1111SC1R11F1(AII IS ISSUFDASAMAIIFROFINIORMAIIONONIY
fka AOn Risk Services Inc Of PA
One Liberty Place
AND CONI FRSNO RICHIS UPON IHF CI R111 ICAIF HOLDER THIS
rke
market Street
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Suite
COVFRAGI Al FORDFDDY IHF POI KIPS DPI OW
Pht 1ad01 pphis PA 19203 USA
PnonF 866 283 7122 F u 847 953 5390
INSURI RS API ORDING COY FRA( F
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Lafarge west Inc
INSURI It American Home Assurance Co
19380
INSURI RD National Union Fire Ins Co of Pittsburgh
19445
1800 North Taft Hill Road
Fort Collins co 80521 USA
INWRI It Insurance Company of the state of PA
19429
INSURI It I) Illinois National Insurance Co
23817
INSUIiI R I
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1606931
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1606932 (MA)
07/01/07
07/01/08
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1606934 (VA)
07/Ol/07
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07/01/08
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07/01/D7
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1616293 (NJ)
07/D1/07
07/Ol/OS
07/O1/08
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DI SCRIPfIOV OP OPPRA l I0N5/LOLATIONS/VI HI< I I SIL%CI USIONS M)UfD BY FNDORSFMI N iSt I CIAO PROVISIONS L
CITY HALL PARKING LOT OVERLAY / JO68 72286
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City of Fort Collins Is Additional Insured (except on
worker s comp) as respects to
insured where required by written contract
operations of the named
-CERTIFICATE
CITY OF FORT COLLINS
NCEI IONR
P 0 BOX 5$0
SHOUIDANYDI THLAIIOVI DISCRIm OPOII(nl Rt CANCIIIIDnIIOPI IIII IXI IRAI IGN
FORT COLLINS CO 80522 USA
DN I Po Rr01 Tlil ISSUING INSURIA WILT I NOCAYOR TO MAII Lr'
tU DAYS wRI fI1NN0110 forPrcOR DICAl1 ❑OIDIRNAMFD
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13UI IAIIURI TOIOWMIAil IMPOSL NO 0131'CAPON OR LIABILITY �-
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Attachment to ACORD Cel hficate for Lafarge west Inc
The teens condtnons vld pinvlslons noted below Elm hcmby IthILIn d to In. c Ipboned CLrllfic tic as adds honal deal Iphon of IhL covtrT6e
dforded by the IPstuer(s) Hu I, allae.hment dOLS not LOntam III Tel nu LOndItlons covuaBLs or exclusions contTUlLd In the poItoy
INSURI D
Lafarge West Inc
1800 North Taft N111 Road
Fort Collins CO 80521 USA
ADDITIONAL POI RALS
INSURLIL
INSURI It
INSURI R
INSURI It
INSURI R
In, pehLy blow does not ,let Lund
adtlficale loon for nolmv INmts
In 01011 relu to the correspondent, policy on
INSR
Lro
AUDI
INSRD
TYPE OEINSUN 1NCi
POII(VNUNIIIVR
101 ICY III S( RIIl ION
101 ICY
ElPE(i IVI
DM
POI ICY
ExP@AaRTS
)A IA
IIMITS
WORKERS COMPENSATION
0
1616294 (OR)
07/01/07
07/(11/08
C
161629S CwI)
07/01/07
07/01/08
.�. ... F;v;; yr vi rnn nonnrwcA I AJN"" lucIA GI xC1 USIONS ADDI D 111 I NUORSI MLNI/SPLC IAl PROVISIONS
Certiflcate No 570028880471