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HomeMy WebLinkAboutTHE WEITZ COMPANY LLC - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE
05/1(6/201YYY)
OS/16/2012
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 1-515-698-4262
CONTACT
NAME:
Construction Surety & Insurance Services, LLC
PHONE FAX
(AIC, NQ E". JAUC, No:
P.O. Box 65428
E#AIL
ADDRESS:
PRODUCER
West Use Moines, IA 50265
CUSTOMER
INSURERS AFFORDING COVERAGE
NAIC#
Maria Matamoros
INSURED
INSURER A: AMERICAN CONTRACTORS INS CO RRG
12300
The Weitz Company, LLC
INSURER B: ACIG INS CO
19984
INSURER C:
5901 Thornton Avenue
INSURER D:
Dee Moines, IA 50321
INSURER E
INSURER F :
COVERAGES CERTIFICATE NUMBER: 27148806 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
rypE OF INSURANCE
ADDL SUER POLICY EFF POLICY EXP
POLICY NUMBER tMWDDIYYY1D (MMIDDrYINT)LIMITS
A
GENERAL LIABILITY
GL12P00005
0610111
06/01/15
EACH OCCURRENCE
$ 5,000,000
A
X COMMERCIAL GENERAL LIABILITY
GL12 PX0005 Excess FP
06/01/1
06/01/15
DAMAAAG 0 RANT D
PREMISES E.tnoummce
$ 100,000
MED EXP(Any one person)
$ 51000
CLAIMS -MADE T OCCUR
PERSONAL$ ADV INJURY
$ 5,000,000
GENERAL AGGREGATE
$ 5,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
$5.000,000
POLICY-X] PRO- LOD
$
AUTOMOBILE
MBILITY
COMBINED SINGLE LIMIT
(Ea accident)
$
ANY AUTO
BODILY INJURY (Per person)
$
ALL OWNED AUTOS
BODILY INJURY (Per accident)
$
SCHEDULED AUTOS
HIRED AUTOS
PROPERTY DAMAGE
(Per accitlenl)
$
$
NON -OWNED AUTOS
8
UMBRELLA MB
OCCUR
EACH OCCURRENCE
S
AGGREGATE
$
EXCESS DAB
CLAIMS -MADE
DEDUCTIBLE
$
$
RETENTION $
B
S
B
WORKERS COMPENSATION
ANDEMPLOYERS'LIABILITY YIN
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICFRIMENE El
(Mandatory in NH)
NIA
WC12000016
KC12 DO0110
WC12000097
0610111
06/01/1
06/01/1
06/01/13
06/01/13
06/01/13
X WC STATU- OTH-
TORYJJMI
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
B
II Yes descdde under
DE SCRIPTION OF OPERATIONS Wave
WC12000111
06/01/1
06 /Ol/13
E.L. DISEASE -POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space is required)
(PA**) Weitz Rocky Mountain: Contractors License.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
PO Sox 580
AUTHORIZED REPRESENTATIVE
Fort Collins, CO 80522
USA
philiphm ©1988-2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD
27148806