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HomeMy WebLinkAboutEXPRESS CONCRETE - INSURANCE CERTIFICATE (6)OP ID KH DATE (MM/DD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE EXPRE-3 1 07 14 09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE LBN Insurance Agcy-Johnstown HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 4848 Tho son Pk Ste 200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. mP T^ri' Johnstown CO 80534 Phone:970-635-9400 Fax:970-635-9401 INSURED Express Concrete, Inc. P.D. Box 273209 Ft. Collins CO 80527 rrnvcaenGc INSURERS AFFORDING COVERAGE I NAIC # INSURER A: Mountain States Insurance Grp INSURER B: INSURER C: INSURER D: INSURER E: 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. POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR INSR TYPE OF INSURANCE DATE MM/DD/YY DATE MM/DD/YV GENERAL LIABILITY EACH OCCURRENCE $ $1 , 000 , 000 _EIUA PREMISES(Eaoccurence) $$100,000 X COMMERCIAL GENERAL LIABILITY CPP0121672 07/13/09 07/13/10 MED EXP (Any one person) $ $10 , 000 CLAIMS MADE X� OCCUR PERSONAL & ADV INJURY $$1,000,000 GENERAL AGGREGATE $ $2, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ $ 2 , 0 0 0 , 0 0 0 POLICY PROJECT LOC A AUTOMOBILE LIABILITY ANY AUTO BAP0121672 07/13/09 07/13/10 COMBINED SINGLE LIMIT (Ea accident) $ $1, 000, 000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS $1000 COMP DED $1000 COLL DED X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO N/A $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE N/A AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below I E.L. DISEASE - POLICY LIMIT T $ OTHER A Property Section CPP0121672 07/13/09 07/13/10 leased eq $100,000 A Equipment Floate CPP0121672 07/13/09 07/13/10 scheduled $389,519 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Driveway/Parking Area or Sidewalk Paving CERTIFICATE HOLDER CANCELLATION CITYFTC 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 City of Fort Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 215 Mason Street REPRESENTATIVES. Fort Collins CO 80521 AUT IWNjRESE( 1A IVY' Aiu A. ACORD 25 (2001/08) © ACORD CORPORATION 1988