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Home My WebLink About497786 MARTIN MARIETTA MATERIALS INC - INSURANCE CERTIFICATE (6)AFRO0912712013 ® CERTIFICATE OF LIABILITY INSURANCE DATE(1YY) 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 Marsh USA Inc. 100 Noah Tryon Street Suite 3600 Charlotte, NC ZB202 Ann: CA NON-RESIDENT NO. DB22889 CONTACT NAMEFAX PHONE c No); E-MAIL ADDRE INSURER(S) AFFORWJ4 COVERAGE mmcF INSURER A: ACE American Insurance Company, 22667 J569651.MMM-GAXWX.13-14 RM201 INSURED Martin Maneaa Materials, Inc. 7In: Todd Crump INSURER B : Indemnity Its Co Of North America 43575 INSURERINSURER C : INSURER D: 2710 Wydi0 Road 1 I P, 0. Box 30013 Raleigh, NC 27622 INSUflER E: INS flER F: CnVFRAr.FS CERTIFICATE NUMBER: ATL-003085657 04 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 TR OF INSURANCE LSUOR ADOTYPE POLICY NUMBER PLDWU/1'YYF POLICY E%P UNITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE M OCCUR HDOG27023927 0913012013 0913012014 EACH OCCURRENCE $ 3,000,000 DAMAGE TO RENTE15 It 50,000 MED EXP (Any One 5010b) $ NIA PERSONAL It ADV INJURY $ 3.000,000 GENERAL AGGREGATE S 6.000,000 GENL AGGREGATE ,_X1 POLICY LIMIT APPLIES PER: PR0. LOC PRODUCTS -COMPIOP AGO $ 6,000,000 S A AUTOMOBILE LUBIUTY ANY AUTO ALL OWNED SCHEDULED AUTOHIRED X NON -OWNED HIRED AUTOS AUTOS Ix ISAH08722249 0913012013 09130/2014rPROPE!RIy COMBINEDSINGLE LIMIT s 3,000,000 RY (Per persm) $ RY(Per accident) S DAMAAUTOS GE $ $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DELI I I RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETONPARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDE09 (Mandatory in NH) II yes, describe under DESCRIPTION OF OPERATIONS below NM WLRC47324518AOS 09131112013 09/3012014 WC STATU- OTH- EL. EACH ACCIDENT 2,000,000 It 2,000,000 E.L. DISEASE - EA EMPLOYE $ 2,000,000 E.L. DISEASE -POLICY LIMIT § 2,OW,000 DESCRIPTION OF OPERATIONS I LOCATIONS 7 VEHICLES (ARseh ACORD 101, Mditlonal Remad to Sc W. It more apses Is reRuimi) Re: Asphat Supply Bid t7377 Asphalt Supply City of Fat Collins islare additional insured under General UabMy and Automobile Liability as IDeu interest may appear, it required by written contract with the named insured subject to the terms and conditions of the policies. As respects General liability Cwerage any additional insured with wham you have agreed to provide such nmcbntnbulory insurance. pursuant to and as required under a written corRactexeGred prig to the date of loss. CERTIFICATE HOLDER CANCELLATION Cry of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO Box 580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN FM Collins, CO 80522 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Lisa F. Beam 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD AFRO® CERTIFICATE OF LIABILITY INSURANCE DATDO YYYY) 09127001712D73 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 Marsh USA Inc. 100 North Tryon Street, Suite 3600 CONTACT NAME: PMIC.HONN l EeFA% Not: E-MAIL Charlotte, NC 28202 Ann: CA NON-RESIDENT NO.OB22BB9 INSURER 8 AFFORDING COVERAGE NAIC• INSURER A: ACE American Insurance Company 22667 J56965-1,MMM-GAXWX-13-14 RM201 INSURED Martin Marietta Materials, Inc. INSURER 9: Indemnify Ins Co Of North America 43575 Attn: Todd Crump INSURER C : _ 271O Wycllff Road P. 0. Box 30013 INSURER D Raleigh, NC 27622 INsuRERe: INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-003104327.04 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 LT TYPE OF INSURANCE I U POLICY NUMBER MYWDDYam, EXP MWDO/ LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR HDOG27023927 09/3012013 D9/3012014 EACH OCCURRENCE $ 3•000•000 A $ 50,000 MED EXP (My we peri If VA PERSONAL It ADV INJURY $ 3,000,000 GENERAL AGGREGATE $ 61000,000 GEN'L AGGREGATE X POLICY LIMIT APPLIES PER: PRI- JECT El LOC PRODUCTS-COMP/OP AGG S 6,ODO,000 $ A AUTOMOBILE UABIIM X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X HIRED AUTOS X NON -OWNED AUTOS ISAHD8722249 09130/2013 09/3012014 COMBINED SINGLE LIMIT fEa Accident) 3000000 BODILY INJURY (Per Person) $ BODILY INJURY (Per axidxs) It PROPERTY DAMAGE (Per accident) $ UMBRELLA LIAa EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION It B WORKER$ COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNEFVEXECUTIVE YIN OFFICER/MEMBER EXCLUDED? F_N] (Mandatory in NH) If ift describe undo, DSCRIPTION OF OPERATIONS below N/A WLRC47324516 A05 OW3012013 09MZ014 X WC STATU- OTN- E.L EACH ACCIDENT $ 2'0�'WD E.L. DISEASE - EA EMPLOYE $ 2,000.000 E.L. DISEASE- POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (AtMah ACORD 101, Additional Remarks Schedule, It more space Is ri irad) RE: Project: Snow & Ice Removal City of Fat Collins is included as additional insured (except workers' compensawn) where required by when contract. City of Fort Collins Alin: Purchasing Department PO Box 580 Fort Collins, CO 80522 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 of hi USA Inc. Lisa F. Beam .--_41L ® 1988-2010 ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD