HomeMy WebLinkAbout452108 EDGE CONCRETE INC - INSURANCE CERTIFICATEFm:Ewing-Leavitt Insurance (19702216707) 08:43 05/11/09GMT-06 Fig 02-03
CORD CERTIFICATE OF LIABILITY
INSURANCE
DATE (MMIDDNYW)
,,
05/11/2009
PRODUCER (970)679-7333 FAX (970)679-7377
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Ewing -Leavitt Insurance Agency
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4025 St. Cloud Dr.
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW.
Suite 100
Loveland, CO 8OS38
INSURERS AFFORDING COVERAGE
NAIC #
INSURED Edge Concrete, Inc.
INSURERA Auto Owners
18988
1533 Taurus Ct. 4110
INSURERS. Owners
32700
Loveland, CO 80537
INSURER
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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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.
INSRADD'
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION
07/31/2009
LIMITS
GENERAL LIABILITY
7400227409
07/31/2008
EACHOCCURRENCE
S ,000 00
A
X COMMERCIAL GENERAL LABILITY
CLAIMS MADE a0CCl1R
DAMAGE TO RENTED
.REMISESIEUN
_
S 300,00
MED ESP (Anyone Pwscn)
5 10,00
PERSONAL & ADV INJURY
S 1,000,00
GENERAL AGGREGATE
S 2,000,00
GEN'L AGGREGATE LIMITAPPLIES PER.
X POLICY PRO-
JECT LOC
PRODUCTS - COMPIOP AGG
a 2,000,00
AUTOMOBILE
LIABILITY
ANY AUTO
4660966000
07/31/2008
07/31/2009
COMBINED SINGLE LIMIT
(Eo accident)
S
1,000,00
B
X
X
X
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AU TOE
NON-OWNLUAUIUS
BODILY pe'son)
(Per parson)
$
BODILY INJURY
(Pe, ocadenU
5
PROPERTY DAMAGE
(Pelacadeet
S
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
S
ANY AUTO
OTHER THAN EA ACC
S
S
AUTO ONLY'. AGO
EXCESSIUMBRELLA LIABILITY
OCCUR CLAIMSMADE
EACH OCCURRENCE
S
AGGREGATE
S
S
DEDUCTIBLE
$
RETENTION D
$
WORKERS COMPENSATION AND
74002269
07/31/2008
07/31/2009
X WCSTFlTU- OTH
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
S 1 000 00
B
ANY PROPRIETOMPARTNERIEXECUTNE
OFRCERIMEMBER EXCLUDED?
If yes. Uesaibe
E.. L. DISEASE - EA EMPLOYEE
S 1,000,00
EL DISEASE-POLICYLIMITS
11000,00
SPECALcnboude, below
PROVISIONS
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES! EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
roject: Soapstone
ertificate holder is named as additional insured as respects general liability.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Director of Purchasing & Risk Management BUT FAILURE TO MAIL SUCH NOTICE SHALLIMPOSE NO OBLIGATION OR LIABILITY
PO Box 580 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE ryl
ncnnn lR ronndmaT FAX- (970)22
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Fm:Ewing-Leavitt Insurance (19702216707) 08:43 05/11109GMT-06 Pg 03-03
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.
Hwrcu Zo tLuuuuut
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