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HomeMy WebLinkAboutEXPRESS CONCRETE - INSURANCE CERTIFICATE (7)OP ID KH DATE (MMlDD/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. Johnstown CO 80534 Phone:970-635-9400 Fax:970-635-9401 INSURED Express Concrete, Inc. P.D. Box 273209 Ft. Collins CO 80527 COVFRAGFS INSURERS AFFORDING COVERAGE 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. L T R�( NSR TYPE OF INSURANCE POLICY NUMBER DATEYMM DED/YY E PO EY MM/DD/YY N LIMITS GENERAL LIABILITY EACH OCCURRENCE $ $1 , 000 , 000 A X COMMERCIALGENERAL LIABILITY CPP0121672 07/13/09 07/13/10 LP) REMi'E3(Eaoccurence) $$100,000 CLAIMS MADE X� OCCUR MED EXP (Any one person) $ $10 , 00 0 PERSONAL & ADV INJURY $ $1 , 000 , 000 GENERAL AGGHEGATE $ $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ $ 2 , OO O , O O O POLICY F7 PROJECT LOC A AUTOMOBILE LIABILITY ANY AUTO BAP0121672 07/13/09 07/13/10 COMBINED SINGLE LIMIT (Ea accident) $$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 $ ANY AUTO N/A OTHER THAN EA ACC $ $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ❑ CLAIMS MADE N/A AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A I TORV LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, dascnbe 6nde, SPECIAL PROVISIONS below -- -- E.L. DISEASE - POLICY LIMIT $ 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 I EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS If required by written contract or written agreement, the City of Fort Collins, its officers and employees are included as Additional Insured for ongoing operations under General Liability and Designated Insured under the Automobile Liability. 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 PO BOX 580 REPRESENTATIVES. Fort Colins CO 80522 AUT4kIWAEjRESEffATIj, a _ - �- A. I ACORD 25 (2001/08) © ACORD CORPORATION 1988