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Home My WebLink About498349 BANNER CONCRETE LLC - INSURANCE CERTIFICATE (2)OP ID: GG 4 �R" CERTIFICATE OF LIABILITY INSURANCE °0 /18/2013 0911812013 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 Phone: 970-635-9400 ONTACT CNAME PFS Insurance Group-JT Fax: 970-635-9401 4848 Thompson Pkvvy, Ste 200 Johnstown, CO 80534 John Hintzman II IX, PHONE FAX Alc No Eat: Arc rvo: EMAIL ADDRESS: PRODUCER BANNE-2 CUSTOMERID/: INSURERS AFFORDING COVERAGE NAIL t INSURED Banner Concretti, LLC I INSURER A: Colorado Casualty Insurance Cc 41785 1408 Steeple Chase Dr INSURERB:PinnacolAssurance Co 41190 Fort Collins, CO 80524 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. NOTWrTHSTAN DING 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INSE Win POLICY NUMBER MMIDDIYYYV MMIDDIYYVY LIMITS GENERALLIABILITY EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 300,00 A X COMMERCIAL GENERAL LIABILITY CiBP5974070 03/01/2013 03/01/2014 CLAIMS -MADE 1XI OCCUR MED EXP(Any one person) $ 15,00 PERSONAL B ADV INJURY $ 1,000,00 X Limited Pollution CBP5974070 03/01/2013 03101/2014 GENERAL AGGREGATE - $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,00 Pollution $ 50,00 POLICY PRO- LOC A AUTOMOBILE X LIABILITY ANY AUTO BAS55065194 02f22/2013 02/22/2014 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Par accident) $ SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ X X NON -OWNED AUTOS MEDICAL PAY $ 5,00 UM/UIM $ 1,000,00 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMSMADENIA DEDUCTIBLE 8 $ RETENTION $ B WORKERS COMPENSATION Arm EMPLOYERSLIABILTY ANY PROPRIETORIPARTNERIEXECLmE YIN OFFICERIMEMBER E(CLUDEDO (Mandatory in NH) NIA 146285 03101/2013 03/01/2014 I WCSTATU. OTH- TORY LIMITS ER ELEACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 I yes, describe a nder DESCRIPTION OF OPERATIONS below EL.DISEASE- POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS IVEHCLES Atlach m ACORD 101, Additional Remarks Schedule, if more space is required) concrete flatwork co>�erical an residentialconcrete flatwork If required y written contract or written agreement, the certificate holder is included as additional insured for ongoing operations under general liability. CTYFC-1 City of Fort Collins Purchsing Dept. 215 N. Mason Fort Collins, CO 80524 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 © 1998-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD