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Home My WebLink About497786 MARTIN MARIETTA MATERIALS INC - INSURANCE CERTIFICATE (2)ACORO® CERTIFICATE OF LIABILITY INSURANCE D05/142012ATE12012 YYYY) 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 endorsements . PRODUCER Marsh USA Inc. 100 North Tryon Street, Suite 3200 CONTACT NAME: PHONE FAX No E-MAIL ADDRESS: Charlotte, NC 28202 Alin: CA NONRESIDENT NO. OB22889 INSURER $ AFFORDING COVERAGE NAIC s INSURER A: ACE American Insurance Company 22667 156965-TMMM-GAXWX-I1.12 INSURED Martin Marren Materials, Inc. (,r� 1 I V Ann: Mr. Todd Crump INSURER a : Indemnity Ins Cc Of North America 43575 INSURER C : NIA NIA 2710 WycUl' Road - PO Box 30013 INSURER D : INSURER E: Raleigh, NC 27622 INSURER F : COVERAGES CERTIFICATE NUMBER: ATL 003089523-01 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 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM/DD/YYYV LIMITS A GENERAL LIABILITY HDOG25532119 0913012011 0913012012 EACH OCCURRENCE $ 3,000,000 % COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR DAMA E TO RENTED PREMISES Ea occurrence $ 50,000 MED EXP (Any one person) $ N/A PERSONAL B ADV INJURY $ 3,000,000 GENERAL AGGREGATE S 6,000•000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ 6.000,000 % POLICY PRO LOC $ A AUTOMOBILE LIABILITY ISAH08692361 0913012011 0913012012 COMBINED SINGLE LIMIT accident) 3,000,000Ea % BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIREDAUTOS % AUTOS % PROPERTY DAMAGE P r bent $ 4 UMBRELLA LIAB OCCUR EACHOCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ B WORKERS COMPENSATION WLRC46771229(AOS) 0913012011 09/30/2012 % I WC STATU- OTH- A AND EMPLOYERS' LIABILITYDRY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A WLRC46771242(MA) 0913012011 09/3012012 LIM E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYE $ 2,000,000 E.L. DISEASE POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space Is required) Re: Project: Annual Asphalt Overlay Renewal 2012 Owner (City of Fort Collins), engineer, engineer's consullanls, their respective offices and employees islare addiumal insured under General Liability (Including Completed Ops) and Automobile Liability as their interest may appear, 8 required by written contact with die named insured, subject to the terms and conditbns of the policies. City of Fort Collins 300 Laporte Ave Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Katherine Firme a— (CyfG�� O 1988-2010 ACORD CORPORATION. All rights reserved. ACOHD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ACORO® CERTIFICATE OF LIABILITY INSURANCE DATEYYYY) 04/24/2012 2012 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 NAMEPHO: Marsh USA Inc. 100 North Tryon Street, Suite 3200 bVC. N A/c No E-MAIL Charlotte, NC 28202 Ann CA NON-RESIDENT NO.0822889 ADDRESS: . INSURERS AFFORDING COVERAGE NAIC s INSURER A: ACE American Insurance Company 22667 J56965 1.MMM-GAXWX-11-12 RM201 INSURED INSURER B: Indemnify Ins Co Of North America 43575 Marlin Madera Materials, Inc. INSURER C : NIA NIA Attn: Mr. Todd Crump INSURER 0: 2710 Wycliff Road PO Box 30013 Raleigh, INC 27622 INSURER E INSURER F : - COVERAGES CERTIFICATE NUMBER: ATL-003086073-03 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 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSfl LTA rypE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MWDD/YYYY POLICY EXP MWDD/YYVV LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR HDOG25532119 09/3012011 09/3012012 EACH OCCURRENCE $ 3,000,000 DAMAX PREkq ETORENT D PREMISES RENT rrence $ SO,000 MED EXP (My one person) $ NIA PERSONAL &ADV INJURY $ 3,000,000 GENERAL AGGREGATE if 6,000.000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO- LOC PRODUCTS- COMP/OP AGG $ 6•000,1300 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS N AUTOS ISAH08692361 09/3012011 0913012012 COMBINED SINGLE LIMIT 0a accldera ? 000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ B A WORKERS COMPENSATION AND EMPLOYERS' LIABILITYen ANY PROPRIETOR/PARTNER EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) II yes,descrice under DESCRIPTION OF OPERATIONS below N/A WLRC46771229(AOS) WLRC46771242(MA) 0913012011 0913012011 0913012012 0913012012 X WC STATU- TST—TO—TH. E.L. EACH ACCIDENT $ 2•�•� E.L. DISEASE - EA EMPLOYE S 2,000,000 E.L. DISEASE -POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It morn spats is required) Re: Project: Harmony Road Maintenance Project; Bid No. 7366 The Owner, (City of Fort Collins), engineer, and engineer's consultants and their respective officers and employees are additional insured under General Liability and Automobile Liability as their interest may appear, if required by written contract with the named insured, subject to the terms and conditions of the policies. City of Fog Collins 300 Laporte AVE Fat Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Katherine Firme .Y "r6e� 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Alk�® CERTIFICATE OF LIABILITY INSURANCE AM (MIN O041M201IDOYYYY � 4 zazolz 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: Marsh USA Inc. PHONE FAX 100 North Tryon Street, Suite 3200 INC. No. EMI NC No : E-MAIL Charlote, NC 28202 Attn: CA NON-RESIDENT NO.OB22889 ADDRESS: INSURERS AFFORDING COVERAGE NAIC e INSURER A: ACE American Insurance Company 22667 J56965 1.MMM-GAXWX.11.12 RM201 INSURED INSURER B : Indemrrty Ins Co Of North America 43575 Martin Marietta Materials, Inc. - INSURER C: NIA NIA Atm Mr. Todd Crump INSURER D: 2710 Wycliff Road PO Box 30013 Raleigh, NC 27622 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: ATL-003085657-01 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 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - INSR LTR TY'PEOFINSURANCE ADOL SUER POLICY NUMBER EFF MM%DD/YVYV MWDICY C Y EXP DNYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE M OCCUR HDOG25532119 09/30/2011 09/3012012 EACH OCCURRENCE $ 3,000.000 DAMP T PREMISES Ea occunxunence $ 50,000 MED EXP (Any one person) $ NIA PERSONAL B ADV INJURY $ 3,000,000 GENERAL AGGREGATE $ 6,000,000 GENT AGGREGATE X I POLICY LIMIT APPLIES PER: PRO- LOC PRODUCTS - COMP/OP AGO $ 6,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOSAUTOSNON-OWNED HIflED AUTOS X AUTOS ISAH08692361 09/30/2011 09/30/2012 1 COMBINED SINGLE LIMIT Ea accident 3,000.000 BODILYINJURY (Per person) $ Ix BODILY INJURY(Per accident) $ POPERTYDAMAGE$ Par eccider, UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE - EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ B A WORKERS COMPENSATION AND EMPLOYERS' LIABILITYLLI ANY PROPRIETORUPARTNEWEXECUTIVE YIN OFFICEWMEMBER EXCLUDED? � (Mandatory in NH) II yes, describe under DESCRIPTION OF OPERATIONS below N/A WLRC46771229(AOS) WLRC46771242(MA) 09130/2011 0913012011 09130/2012 0913012012 X WCSTAT% OTH- JE E.L. EACH ACCIDENT 2,000,000 $ E.L. DISEASE- EA EMPLOYE 2,000,000 E.L. DISEASE- POLICY LIMIT I 2.000,000 S DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Re: Asphalt Supply - Bid Y7377 Asphalt Supply City of Foil Collins islare additional insured under General Lability and Automobile Liability as their interest may appear, if required by written contract with the (lamed insured subject to the terms and conditions of the policies. As respects General lability Coverage any addaonal insured man venom you have agreed to praide such nm-cmuibutay insurance, pursuant to and as required under a wmtm contract executed prior to the date of loss. City of Fort Collins PO Box 590 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Katherine Firme 1988-2010 ACORD CORPORATION. All rinhtS rnsnrvnd_ ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD