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Home My WebLink About452108 EDGE CONCRETE INC - INSURANCE CERTIFICATE (4)TJ�l.7�1 CERTIFICATE OF LIABILITY INSURANCE DATE o7/18/2011s/zoll THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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). PRODUCER CONTACT NAME: Ewing -Leavitt Insurance Agency PHONA/CC,No Eat:970.679.7333 aDNe;866.456.4265 4025 St. Cloud Dr. E-MAIL ADDRESS: Suite 100 Loveland, CO 80538 PRODUCER 00004870 CUSTOM_ER ID N: INSURERS) AFFORDING COVERAGE NAICN INSURED INSURER A: Secura Insurance G9407 Edge Concrete, Inc. INSURERB: Pinnacol Assurance 41190 1533 Taurus Ct. #110 INSURERC: Loveland, CO 80537 INSURER D: INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: 11/12 REVISION NUMBER: THIS IS TO CERTIFY THAT 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 CONTRACTOR 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, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR MD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MM/DDNYYYf LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX] OCCUR X Bl kt Addl t Insd TC31S287507/3112011 07/31/2012 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES(Eeo¢rm unce $ lOO, OOD MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY If Included X Bl kt WOS GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY X PRO- ECT LOC PRODUCTS - COMP/OP AGG S 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NONOWNEDAUTOS A315287607/3112011 07/31/2012 COMBINED BINEDl'INGLE LIMIT $ 1,000, 000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per socidenl) $ X X $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION ANDEMPLOVERS'LIABlLITY ylR OIFICERIMEM EREXICLUDED?ECUTIVE❑ (Mandatory In NH) If yes describe under DESCRIPTION OF OPERATIONS below NIA 413347208101I-011 OW01/2012 X WCSTAFU- OTH-�— T RV LIMIiS ER E.L. EACH ACCIDENT $ I,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 EL DISEASE -POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) roject: Soapstone ertificate holder is named as additional insured as respects general liability. FAX: 970.221.6707 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Director of Purchasing & Risk Management AUTHORIZED PO Box 580 Fort Collins, CO 80522 vatic M, All Anhfc roennmd ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD