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HomeMy WebLinkAboutMETRO PAVERS INC - INSURANCE CERTIFICATE (3)IMhIHU-z upIU:VIM AI�R� ATE (MMIDONYYY) CERTIFICATE OF LIABILITY INSURANCE D09/19/2013 09/19/2013 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 endomement(s). PRODUCER ice Group - JT son Pkwy, Ste 200 CO 80534 INSURED Metro Pavers, Inc. P O Box 601 Henderson, CO 80640 Phone: 970.635-940C Fax:970-635-9401 - IINSURERA:Travelers Companies INSURER B COVERAGES CFRTIFICATFNUMRFR- RFV14lnM MI1MRFR- 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. WSR TYPE OF INSURANCE ADOLSUB" INIR POLICY NUMBER POLICY EFF POMCEYLEP MM/DD/YYYY MM/DDIYYW UNITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,00 PREMISE$-(ERsENTED- II 300,ON A X COMMERCIALGENERAL LIABILITY DTCO2C9908061ND13 10/01/2013 10/01/2014 MED EXP(Any one person) -PERSONAL $ 5,001 CLAIMS -MADE X OCCUR S ADV INJURY $ 11000 X Add9 Ine'd GENERAL AGGREGATE S 2,000,001 X VVvr Of Sub PRODUCTS -COMPIOP AGG S 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO- F7 LOG S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea exlaen0 11 1,000, BODILY INJURY (Per peson) S A AlANY AUTO DT8102C99080BTIL13 10/01/2013 10/01/2014 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per eoddenl) S HIRED AUTOS NON -OWNED AUTOS PROPERTYDAMAGE Pe epdgent S s X 1,000 Comp X 1,000 Coll X UMBRELLA UAB X OCCUR EACH OCCURRENCE S 10,0001 $ 10,000,000 A EXCESS LIAM CLAIMS�MADE DTSMCUP2C990808TIL13 10/01/2013 10/01/2014 AGGREGATE $ 'DED X I RETENTION$ 10,000 A, WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVEYIN OFFICER/MEMBER EXCLUDED? NIA DTJUB3CO2224213 (Mandatory in NH) X WC STATU- X OTH- -- TO LIMMSER 1010112013 10N1/2014 E.L. EACH ACCIDENT _. E. L. DISEASE - EA EMPLOYEE S 1,000,0 $ 1,000 K yes. desa,be under DESCRIPTION OF OPERATIONS below - "'-- -- E.L. DISEASE-POLICYLIMIT - -' $ 1,000,001 A Buildings Limit DTCO2C9908081ND13 10/0112013 10/01/2014 Limit 616,001 A Leased/Rented Limi DTCO2C9908081ND13 10/01/2013 10/01/2014 Limit 100, DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remark, Schedule, N nu, a We Is nequind) If required by written contract or written agreement, the certificate holder is included as additional insured for ongoing operations under general liability. FTCOLLI City of Fort Collins P.O. 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 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010/06) The ACORD name and logo are registered marks of ACORD