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HomeMy WebLinkAboutMETRO PAVERS INC - INSURANCE CERTIFICATEMETRO-2 OF ID: VM 41`oRo CERTIFICATE OF LIABILITY INSURANCE DA 10/02/12 1 olazn 2 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 . paooucER Phone: 970-635-9400 CONTACT PFS Insurance Group - LIT 4848 Thompson Pkwy, Ste 200 Fax: 970.635-9401 Johnstown, CO 80534 Mark Polk PHONE FA% qlC No Eat: AID, No): E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Travelers Companies - 25615 INSURED J Metro Pavers, Inc. 7875 1.76 Service Road INSURER B: Henderson, CO 80640 INSURER C: INSURER D INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 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. .r INGR ADOL SUER POLICY EFF�FPOLIC YYYY LTR TYPE OF INSURANCE POLICY NUMBER MMMDNYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIALGENERALLIABILITY CLAIMS -MADE 1K OCCUR DTCO2C9908081ND12 10/01/12 10/01/13 DAMAGE TO RENTED PREMISES (Ea eecnnence) MED ESP (Any one person) $ 300,00 $ 5,000 X Addlns'd PERSONAL & ADVINJURV $ 1,000,000 X Wvr Of Sub GENERAL AGGREGATE $ 2,000,000 GEMLAGGREGGA�AT��E LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,00 POLICY X JECTPRO n LOG $ A AUTOMOBILE LIABILITY ANY AUTO DT8102C990608TIL12 10101112 10101113 COMBINE. SINGLE LIMIT (Ea —d.nt) $ 1,0DD,D0 BODILY INJURY (Per person) $ ALLOWNED SCHEDULE. AUTOS AUTOS BODILY INJURY (Per acutlenQl$ NON-0VvNEO HIREDAUTOS AUTOS PROPERTY DAMAGE (Per accident) $ $ X 1,000 Comp X 1,000 Coll X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,00 A EXCESS LIAB CLAIMS -MADE DTSMCUP2C990808TIL12 10/01/12 10/01/13 AGGREGATE $ 5,000,000 DEpTX RETENTION$ 10,0ool $ COMPENSATION y�. I y ITT A AND EMPLOYERSWORKERS ' OFFICERIMEIMBOREXOLUDEWECUTIVEY� (Mandatory in NH) NIA DTJUB3CO2224212 10/01112 10/11M3 RSTATTS ^ IOER $ 1,000,000 E.L. EACH ACCIDENT E. L. DISEASE -EA EMPLOYEE $ 1,000,000 It yes, describe under DESCRIPTION OF OPERATIONS below _ EL DISEASE -POLICY LIMIT $ 1,000,00 q Buildings Limit - DTCO2C9908081ND12 10101112 10101113 Limit 615,00 q Leased/Rented Limi DTCO2C990808IND12 10101112 10/01113 Limit 100,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) If required by written contract or written agreement, the certificate holder Is included as additional insured for ongoing operations under general liability. City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 FTCOLLI 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 � `rw`�'� ©1988-2010 ACORD reserved, ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD