Loading...
HomeMy WebLinkAbout498349 BANNER CONCRETE LLC - INSURANCE CERTIFICATE./� UP ID: KH ,d►coRO CERTIFICATE OF LIABILITY INSURANCE FDATE 11201 VYI 02/1112014 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 PFS Insurance Group - JT 4848 Thompson Pkwy, Ste 200 Johnstown, CO 80534 John Hintzman INSURED tlanner L:Oncrete, L.L.I. I /� �� 1408 Steeple Chase Dr 47 3 Fort Collins, CO 80524 COVERAGES CERTIFICATE NUMBER: BANNE-2 INSURER(S) AFFORDING COVERAGE Colorado Casualty Insurance Co Pinnacol Assurance Co 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 OF INSURANCE POLICY EFF POLICY NUMBER MM/DDIYYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X Limited Pollution BKS1555371437 '.. 03/01/2014 BKS1555371437 03/01/2014 03/01/2015 03/01/2015 EACH OCCURRENCE $ 1,000,00 _DAMAGrM RENTED PREMISES Eaowunence $ 300,00 MED EXP (Any one person) $ 15,00 PERSONAL& Al INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC PRODUCTS-COMP/OP AGG $ 2,000,00 Pollution $ 50,00 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BA1555065194 0212212014 02I22/2016 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 $ X BODILY INJURY (Per person) BODILY INJURY (Per accident) $ PROPERTY DAMAGE (PER ACCIDENT) $ X X MEDICAL PAY $ 5,00 UM/UIM $ 1,000,00 UMBRELLA LIAB EXCESS LUIB OCCUR CVUMS-MADE NIA EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes describe under DESCRIPTION OF OPERATIONS below MIA 146285 I 03/01/2014 03/01/2015 I WC STATLIMU- OTH- ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE -POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it 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. CTYFC-1 City of Fort Collins Purchasing 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 41�� © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD