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Home My WebLink About102511 LAFARGE NORTHERN INC - INSURANCE CERTIFICATE (7)�"12 ;,, V 7e-j e��l CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 07/27/2009 PRODUCER Aon Risk services Central, Inc. Philadelphia PA Office One Liberty Place 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 1650 Market Street COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 1000 INSURERS AFFORDING COVERAGE NAIC # Philadelphia PA 19103 USA PHONE-(866) 283-7122 FAX-(847) 953-5390 INSURED INSURER A: National Union Fire Ins Co of Pittsburgh 19445 INSURERB: Insurance Company of the State of PA 19429 Lafarge west, Inc 1800 North Taft Hill Road, INSURERC: Granite State Insurance Company 23809 Fort Collins CO 80521 USA INSURER D: Illinois National Insurance Co 23817 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. LIMITS SHOWN ARE AS REQUESTED INSR LTR ADD' INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE(MM/DD/YYYY POLICY EXPIRATION DATE(MM/DD/YYYY) LIMITS A .ENERAL LIABILITY GL9723097 (CM) 07/01/2009 07/01/2010 EACH OCCURRENCE $2,000,000 DAMAGE TO RENTED $ 500 , 000 X COMMERCIAL GENERAL LIABILITY X CLAIMS MADE OCCUR PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY $2,000,000 ❑ GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 ❑X POLICY PECT LOC A A A AUTOMOBILE LIABILITY X ANY AUTO CA1607650 CA1607651 (MA) CA1607652 (OR) 07/01/2009 07/01/2009 07/01/2009 07/01/2010 07/01/2010 07/01/2010 COMBINED SINGLE LIMIT (Ea accident) $2,000,000 BODILY INJURY — A X ALL OWNED AUTOS CA1607653 (VA) 07/01/2009 07/01/2010 SCHEDULED AUTOS ( Per person) X HIRED AUTOS BODILY INJURY X NON OWNED AUTOS (Peraccident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGG EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE ❑ OCCUR n CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION B C D C D B WORKERS COMPENSATION AND EMI'LOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE El OFFICER/MEMBER EXCLUDED? (Mandatory in NH) Ifycs, describe under SPECIAL PROVISIONS below WC 4 7 AOS wC5145488 (CA) (FL) wC5145490 (LA,etc) WC5145491(MI) wc5145492 (NJ) 07/01/2009 07/01/2009 07/01/2009 07/01/2009 07/01/2009 07/01/2009 07/01/2010 07/01/2010 07/01/2010 07/01/2010 07/01/2010 X WC STATU- TORv LIMITS OTH- ER E.L. EACH ACCIDENT $2,000,000 E.L. DISEASE -EA EMPLOYEE $2,000,000 E.L. DISEASE -POLICY LIMIT $2,000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS City Of Fort Collins is included as Additional Insured (except on workers' Compensation) as respects to operations of the named insured where required by written contract. waiver of subrogation is granted in favor of certificate holder as required by written contract but limited to the operations of the insured under said CERTIFICATE HOLDER CANCELLATION e City Of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION PO BOX 580 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 215 N . Mason St 2nd Floor 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Fort Collins CO a0522 USA BUT FAILURE To DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVEn �O,�rs�c Jaor64 ��a ACORD 25 (2009/01) (D1988-2009 ACORD CORPORATION. All rights reserve The ACORD name and logo are registered marks of ACORD O x Attachment 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). This 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 INSURER INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR ADD'L INSRD TYPE OF INSURANCE POLICY NUMBER POLICY DESCRIPTION POLICY EFFECT IVE DATE POLICY EXPIRATION DATE LIMITS _ WORKERS COMPENSATION A wc5145493 (OR) 7/01/2009 07/01/2010 B wc5145494 (wI) 7/01/2009 07/01/2010 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS contract, and always subject to the policy terms, conditions and exclusions. Certificate No : 570035599940