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HomeMy WebLinkAboutTERREL CONSTRUCTION LLC - INSURANCE CERTIFICATEACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE 12/9/2009 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION JOE P YOUNGMAN (13581) ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2595 CANYON BLVD HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR STE 315 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. BOULDER, CO 80302-0000 303-443-5745 FAX:303-443-0396 INSURED 0867410 TERREL CONSTRUCTION LLC PO BOX 473 NIWOT, CO 80544 CnVFRAnFA INSURERS AFFORDING COVERAGE INSURERA: COUNTRY Mutual Insurar INSURER B: INSURER C: INSURER D: INSURER E: NAIC # 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. INS LT 13131 pOLICYNUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS A GENERAL LIABILITY ❑ COMMERCIALGENERAL LIABILITY AB9022633 4/29/2009 4/29/2010 EACHOCCURRENCE $1,000,000 AMA PREMISES Eaoccurence $100,000 CLAIMSMADE E] OCCUR MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 ❑ ❑ GENERALAGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OPAGG $2,000,000 70 POLICY ® PRO - LOC AUTOMOBILE ❑ LIABILITY ANYAUTO COMBINED SINGLE LIMIT (Ea accident) ❑ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) BODILY INJURY (Per accident) ❑ HIRED AUTOS NON -OWNED AUTOS PROPERTYDAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT ❑ ❑ ANY AUTO OTHERTHAN EAACC AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE ®il I OCCUR 01 CLAIMS MADE AGGREGATE ❑ DEDUCTIBLE RETENTION $ WORKERS COMPENSATION ANDCRY LIM WC STATU- ®OTH- I ER EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERWEMBER EXCLUDED? ❑ NO E.L. EACH ACCIDENT E.L. DISEASE- EA EMPLOYEE Des describe under SPECIAL PROVISIONS below 0 Yes E.L. DISEASE -POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION CITY OF FORT COLLINS P O BOX 580 FORT COLLINS, CO 80522 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. AUTHORIZED REPRESENTATIVE 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 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)