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Home My WebLink AboutLAFARGE WEST INC - INSURANCE CERTIFICATE (4)A CORD.. CERTIFICATE OF LIABILITY INSURANCE DATE03i 2/2009Y) PRonuceli APRODUCER Risk services Central, Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY Philadelphia PA Office AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. "PHIS One Liberty Place 1050 Market Street suite 1000 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY TDE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIL q Philadelphia PA 19103 USA PHoNE-(866 283-7122 FAX-(847) 953-5390 INSURED INSURER Ai National Union Fire Ins co of Pittsburgh 19445 Lafarge west, Inc 1800 North Taft Hill Road, Fort Collins co 80521 USA INSURER B: American Home Assurance Co. 19380 INSURIaa C: Insurance Company of the State of PA 19429 INSURER D: Granite State Insurance Company 23809 INSURER E: Illinois National Insurance CO 23817 COVERAGES 1 HE POLICIES OP INSURANCE LISTED BELOW I1AVE BEEN ISSUED TO "1'HE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO1WI'I'IISTANDING ANY REQUIREMENT,'] REM OR CONDITION OF ANY CONTRACTOR 0.11 IER DOCUMENTWITH RESPECT] OWIHCH 9'HIS CERIIPICA'1'E MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED 13Y'I HE POLICIES DESCRIBED HEREIN IS SUINEC'I'1-0 ALL THE I ERMS, EXCLUSIONS AND CONDITIONS OF SUCII POLICIES. AOGREGA'11; LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, LIMITS SHOWN ARE AS REQUESTED INSR LTR ADD-1 INSRX TYPROFINSURANCE POLICY NUMBER POLICY EFFECTIVE DA'IE(MM\)DWY) POLICY EXPIRATION DATF.(MM\DD\YY) LIMITS B GENERALLIADILITY COMMERCIAL GBNIi12AL LIABIIA'fY GL9723097 (CM) 07/01/08 07/01/09 EACH OCCURRENCE $2,000,006 DAMAGE NORENTED $500,000 CLAIMS MADE OCCUR H PREMISES(1la oecurence) ML (Anv one ncrson) 5 PERSONAL& ADV IN)URY $2,000,000 ❑ GENERAL AGGREGATE $2,000,000 GENT, AGGREGA IE LIMIT APPLIES PER: PRODUCTS - COME'/OPAGG $2,000,000 ❑X POLICY PRO- ❑ OC JI:CI' A A A q AUTOMOBILE X X LIABILITY ANYA' NO nu. owwan nuros CA1607650 CA1607651 (MA) CA1607652 (OR) CA1607653 (VA) 07/01/08 07/01/08 07/01/08 07/01/08 07/01/09 07/01/09 07/01/09 07/01/09 COM13INISD SINGLE LIMIT (13a accidcn0 $2,000,000 BODILY INJURY scelsnuu;n nu ros (r« Person) )( FIRED All I'OS BODILY INJURY X NON OIVNLD AU'IUS (I'cr nccinen0 PROPERTY DAMAGE (Per aaiJmn) GARAGE LIABILITY AUTO ONLY - LA ACCIDEN I' e ANY All'IO 011ilill "IIIAN 13A ACC nUTOONLY AND EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE ❑ OCCUR ❑ CLAIMS MADE AGGREGA11i DEDUCTIBLE RIiIEN'TION C D E D E C WORKERS COMPENSATION AND EMPLOYERS' LIABILLI V ANY PROPRIETOR OPFICGR/MIiMBIiR EXCLUDED?EL. Ill, R,cni umter SPECIAL PROVISIONS Mlov WC 4 AOS WC5145488 (CA) WC5145489 (FL) WC5145490 (LA,etc) WC5145491(MI) wcS145492 (NJ) 7 1 0710110 07/01/08 07/01/08 07/01/08 07/01/08 07/Ol/09 07/01/09 07/01/09 07/01/09 07/01/09 X' WC S'1'A1'U- T IYL1MIIS 0TH- PR rA- EACH ACCIDEN T $2,000,000 DISEASE -EA EMPLOYEE $2,000,000 ) lil pISEnS6POUcv LIMIT $2,000,000 OTHER DESCRIPTION OF OPEIA7IONS/LOCAL'IONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: City of Fort Collins Asphalt supply, Job No. 6045. City of Fort Collins is Additional Insured (except on Workers' compensation) as respects operations of the Named insured where required by written contract. i CERTIFICATE HOLDER- `CANCELLATION City Of Fort Collins Administrative services Purchasing Div. Attn: James B. O'Neill 215 North Mason, 2nd Floor PO Box 580 SHOULD ANY OF I'IIF ABOVEDESCRIBED POLICIES@ECANCELLED RE ORE I B'I'XPIRA'I'ION - CAT'IHEIiEOF II IE ISSUING INSURER Will, ENDEAVOR TO MAIL 30 DAYS WRITIl3N NOTICE '1'0'11110 C—IFICA'rE HOLDER NAMED 1'01'HE LFFE BUT 'I'AIIARETO DO SO SHALL IMPOSE NO OBI,IGA'] IONOR LIABILI I OF ANY KIND UPON TUE. INSURER, IS AGI N'PS OR REPRESENTATIVES, j nurlloairro REPRCSENI'n'rrvr: QVe: Fort Collins CO 80522-0580 USA 'ACORD 25` 2001/08 'ACORD CCORPORATION 1988 rsIi Attactunent to ACORD Certificate for Lafarge west, Inc The terms, conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the coverage afforded by the insurer(s).'rhis attachment does not contain all terms, conditions, coverages or exclusions contained in the policy. INSURED Lafarge west, Inc 1800 North Taft Hill Road, Fort Collins CO 80521 USA ADDITIONAL POLICIES INSURER If a policy below does not includ certificate form for policy limits. to lire corresnondine nolicv on the ACORD INSR Urn ADD'L INSRD TYPE OF INSURANCE POLICY NUMBER POLICY DESCRIPTION POLICY EFFECTIVE DATE" POLICY F,XPIRA'I'ION DATE, LIMITS WORKERS COMPENSATION A wC5145493 (OR) 07/01/08 07/01/09 C wC5145494 (WI) 07/01/08 07/01/09 DESCRIVI ION OF OPERATIONS/LOCAL'IONS/V11HICI.US/ERCIASIONS ADDED BY ENDORSEMENT'/SPECIAL PROVISIONS Certificate No : 570033343554