HomeMy WebLinkAbout108423 VOGEL CONCRETE INC - INSURANCE CERTIFICATE (3)UP IU: KH
'`"-"''" CERTIFICATE OF LIABILITY INSURANCE DATE /151201 VV)
�� 01/15/2014
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
PRODUCER
PFS Insurance Group - JT
4848 Thompson Pkwy, Ste 200
Johnstown, CO 80534
Tad Borrett
INSURED Vogel Concrete, Inc.
6330 S College Ave 42.
Fort Collins, CO 80525-4044
INSURER 0 :
INSURER E :
VOGEL-1
Auto Owners Insurance
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
18988
a
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
POLICY NUMBER
POLICY
MMIDDIYEYYY
MMID POLICYFF EXP
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE O OCCUR
X bink addl ins
74037316
01/17/2014
0111712016
EACH OCCURRENCE
$ 1,000,00
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 300,00
MED EXP (Any one person)
$ 10,00
PERSONAL $ ADV INJURY
$ 1,000,00
GENERAL AGGREGATE
$ 2,000,00
GEML AGGREGATE LIMIT APPLIES PER:
POLICY FX7 PRO- 71 LOC
PRODUCTS - COMPIOP AGG
$ 2,000,00
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
4709905200
01/17/2014
01/17/2015
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,00
X
BODILY INJURY (Par person)
S
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(PER ACCIDENT)
$
X
X
$
$
� IIABX
LUBCLAIMS-MADE
7CE
OCCUR
7-099052-03
01117/2014
01/17/2015TIBLE
EACH OCCURRENCE
$ 1,000,0008
AGGREGATE
$ 1,000,A
RETENTION $
$
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED9
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
WC STATU- OTH-
TORYLLIMITS
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
$
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required)
if requfired by written contract or written agreement, certificate holder is
included as additional insured for ongoing operations under General
Liability.
FTCOLLI
City of Ft. Collins
Purchasing Division
215 Mason Street
P.O. Box 580
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
91988-2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD