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HomeMy WebLinkAboutVOGEL CONCRETE - INSURANCE CERTIFICATE (4)OP ID KH ACORD CERTIFICATE OF LIABILITY INSURANCE VOGEL-1 DATE (MM/DD/YYYY) 06 03 09 PRODUCER LBN Insurance Agcy-Johnstown 4848 Thompson Pkwy, Ste 200 Johnstown CO 80534 Phone : 970-635-9400 Fax: 970-635-9401 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Vogel Concrete, Inc'. 6330 S College Ave Fort, Collins CO 80525-4.04.4. INSURER A: Pinnacol Assurance - 41190 INSURERS: Auto -Owners Insurance Co.- 18988 INSURER C: 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 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE Fx� OCCUR X bink addl ins 74006127 01/17/09 01/17/10 EACH OCCURRENCE $ 1000000 PREMISES(Eaoccurence) $ 300000 MED EXP (Any one person) $ 10000 PERSONAL & ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PROECT LOC J PRODUCTS - COMP/OPAGG $ 2000000 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS ,. 4709905200 01/17/09 01/17/10 COMBINED SINGLE LIMIT (Ea accident) $ 1000000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X :• PROPERTY DAMAGE $ GARAGE LIABILITY - - ANY AUTO - N/A .. - _... _ - - AUTO ONLY - EA ACCIDENT $ - - OTHER THAN , - EA ACC AUTO ONLY: AGG $ - $ EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ N/A EACH OCCURRENCE $ AGGREGATE $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 4102132 07/01/09 07/01/10 X I TORY LIMITS ER E.L. EACH ACCIDENT $ 100000 E.L. DISEASE - EA EMPLOYEE $ 100000 E.L. D!SEASE- POL!CY LIMIT- -$-50.0000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS The Certificate Holder is listed as Additional Insured in regard to the General Liability. CERTIFICATE HOLDER CANCELLATION City of Ft. Collins Purchasing Division 215 Mason Street P.O. Box 580 Ft. Collins, CO 80522-0580 FTCOLLI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. ACORD 25 (2001/08) © 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 t 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. ACORD 25 (2001/08)