HomeMy WebLinkAbout452108 EDGE CONCRETE INC - INSURANCE CERTIFICATE (3)ACORD CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
o7/21/2010
PRODUCER 970.679. 7333 FAX 866.456.4265
Ewing -Leavitt Insurance Agency
4025 St. Cloud Dr.
Suite 100
Loveland, CO 80538
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 COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED Edge Concrete, Inc.
1533 Taurus Ct. #110
Loveland, CO 80537
INSURER A: Secura Insurance
G9407
INSURER Pinnacol Assurance
41190
INSURERC:
INSURER D:
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.
INSR
LTR
DD'
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM/DD/YYYY
POLICY EXPIRATION
DATE MM/DD/YYYY
LIMITS
GENERAL LIABILITY
TC3152875
07/31/2010
07/31/2011
EACH OCCURRENCE
$ 1,000,000
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 1•-I OCCUR
IX:lBl]kt
DAMAGES (RENTEDPREMISES (Ea occurrence)
$ 100,000
MED EXP (Any one person)
$ 5,000
A
Addtl Insd
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000,000
X POLICY PERLOC
JECT
AUTOMOBILE
LIABILITY
ANY AUTO
A3152876
07/31/2010
07/31/2011
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
BODILY INJURY
(Per person)
$
A
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON -OWNED AUTOS
X
X
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESS / UMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR ❑ CLAIMS MADE
AGGREGATE
$
$
DEDUCTIBLE
$
RETENTION $
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
P,NY PROPRIFTOR,rPAR?NEP,D? (EXECUTIVE
OFFICER/MEMBER EXCLUDE(
u—
4133472
08/01/2010
08/01/2011
X- I Two RY LIMITS OETIH
E. L. EACf-I ACCIDENT
$ 1,000,000
E.L DISEASE - EA EMPLOYEE
$ 1,000,000
(Mandatory in NH)
If yes, describe under
E.L. DISEASE - POLICY LIMIT 1
$ 1,000,000
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
roject: Soapstone
Certificate holder is named as additional insured as respects general liability.
C:ttt I ItI(:A I t HULUtR CANCELLATION
Director of Purchasing & Risk Management
PO 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 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
Katie McAvo /KAMCAV
m%1%Jr�u ca tcvumv rl fAA: 9/U. ZZ1. b/U/ V 19t5t$-ZUUy ACUKU GORPORATION. All rights reserved.
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