HomeMy WebLinkAbout128247 PIONEER SAND COMPANY INC - INSURANCE CERTIFICATE (9)30834
ACORD,M CERTIFICATE OF
LIABILITY INSURANCE
DATE(MM/DD/YYYY)
1 /4/2010
PRODUCER Commercial Lines - (719) 592-1177
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Wells Fargo Insurance Services USA, Inc.
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
-
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
5755 Mark Dabling Blvd., Suite 300
Colorado Springs, CO 80919-2228
INSURERS AFFORDING COVERAGE
NAIC #
INSURED Pioneer Sand Company, Inc
!y j !, Ii JAN
14 ZU111INSUkER
A: Liberty Mutual Insurance Co.
23043
INSURER B: Great American Insurance Company
16691
Pioneer Landscaping Materials, Inc
;' �u
INSURER C: Pinnacol Assurance
PO Box 7650
INSURER D: AlllanZ Global Risk
Colorado Springs, CO 80933
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
INSR
TYPE OF INSURANCE
POLICY NUMBER
PDALTEYMMFDD/YYE
POLICY
DATE MM/DD/YY N
LIMITS
A
GENERAL LIABILITY
TBJ-Z91-439861-030
1/01/2010
1/01/2011
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 100,000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE M OCCUR
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000,000
POLICY X PE� El LOC
A
AUTOMOBILE
LIABILITY
ANY AUTO
ASJ-Z91-439861-020
1/01/2010
1/01/2011
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
F
$
AUTO ONLY: AGG
B
EXCESS/UMBRELLA LIABILITY
T000016660-00
1/01/2010
1/01/2011
EACH OCCURRENCE
$ 25,000,000
X OCCUR CLAIMS MADE
AGGREGATE
$ 25,000,000
$
$
RXDEDUCTIBLE
$
RETENTION $ 10000
C
-
WORKERS COMPENSATION AND
-EMPLOYERS'
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
4018785
_ y
2/01/2010
-
2/01 /2011
TH
X ORY IMWC ITS OER
C.H-ACCIDENT-- —. _
E.L. —$
- 500,000 -
E.L. DISEASE - EA EMPLOYEEI
$ 500,000
OFFICER/MEMBER EXCLUDED?
If yes, describe under
E.L. DISEASE - POLICY LIMIT
$ 500.000
SPECIAL PROVISIONS below
OTHER
D
Inland Marine/Property
MX198476005
1/01/2010
1/01/2011
$10,000,000
D
Leased/Rented Equipment
MX198476005
1/01/2010
1/01/2011
$ 1,000,000
D
Motor Cargo Legal Liability
MX198476005
1/01/2010
1/01/2011
$ 100000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
RE: Bid #5148 Infield Soil Mix
%1r_rrt 1 Ir-R—K t r_ nvLur=rN L A NI.tLLA I IVN ' "" —Y ' —1— "" ' ""'' ' uy"'.".
City of Ft. Collins
PO Box 580
Ft Collins. CO 80522-0580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 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 /J
ACORD 25 (2001/08) 1 Of 2 1 I U / UJ4 0 ACORD CORPORATION 1988