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Home My WebLink About452108 EDGE CONCRETE INC - INSURANCE CERTIFICATE (6)ACORD CERTIFICATE OF LIABILITY INSURANCE TM DATE02/2013 OS/02/2013 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 Ewing -Leavitt Insurance Agency 4025 St. Cloud Dr. CONTACT NAME: Dustin Sadowski PHHONNaEa:970.679.7375 uc,Ne):866.456.4265 DDRRss: dustin-sadowski@leavitt.com Suite 100 r a Loveland, CO 80538 �> 11�A INSURER(S) AFFORDING COVERAGE NAICN INSURER A: Secura Insurance 22543 INSURED Edge Concrete, Inc. INSURERB: Pinnacol Assurance 41190 1040 South Railroad Avenue INSURER C: Loveland, CO 80537 INSURER D: INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 13/14 Master 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 OFINSURANCE INSRIWVD BUSH POLICY NUMBERAUDL POLIC MMIDDIYYEFF YY MMIDDIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I OCCUR X Blkt Add't Insd TC3152875' 07131/2013 07/31/2014 EACHOCCURRENCE $ 1,000,000 PREMISES RENTEDence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ Included X Blkt Waiver of Sub GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY A—PECT RDT � LOC J PRODUCTS - COMPIOP AGG $ 2,000,00 $ B AUTOMOBILE LIABILITY ANY AUTO ALLOWNED SCHEDULED AUTOS 'X AUTOS HIRED AUTOS X NON -OWNED AUTOS 413347208/01/2013 08/0112014 Ea accident $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTPDAM1IA Per accident $ Is UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ ' DEO I I RETENTIONS I $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY OFFICERIMEMBEER EXCLUDED? PROPRIETOR/PARTNERJEXECUTIVFj (Mandatory In NH) u If Yes describe under DESCRIPTION OF OPERATIONS below NIA 4133472:0810112013 0811112114 X A TORY LIMIT$ ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1.000.000 A Leased & Rented Equipment TC31528750713112013 0713112014 $25,000 Limit $500 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Project: 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 PO Box 580 Fort Collins, CO 80522 MIM ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD