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HomeMy WebLinkAbout353928 CONCRETE STABILIZATION TECHNOLOGIES INC - INSURANCE CERTIFICATE (4)ACORa CERTIFICATE OF LIABILITY INSURANCE DAMIMMlDD V YI 1 /2/2014 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 certificate holder in lieu of such endorsements . PRODUCER Van Gilder Insurance Corp. 1515 Wynkoop, Suite 200 Denver CO 80202 CONTACT NAME: PHONE FAX No E-MAIL Ess,contractorsavoic. corn INSURE S AFFORDING COVERAGE NAICIs INSURER A:pqnnacoI Assurance INSURED (� Stabilization Technologies, Inc 3531Z 8500 E. Warren Avenue I Denver CO 80231 Concinnat Insurance Company INSURER IIIConcrete INSURERc: INSURER D: INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: 75967264 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. IFF LTR TYPE OF INSURANCE N R VWD POLICY NUMBER MMNDY/YYW MMUCY E%P LIMITS C GENERAL LUUIRRY BV01462568 1/1/2014 11112015 EACH OCCURRENCE $1,000000' RENTED PREMISES(Ea dmunence $50,000 X COMMERCIAL GENERAL LIABILITY NED EXP (Any one Perim) f CLAIMS -MADE � OCCUR PERSONAL&ADV INJURY $1.000.000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000. Deductible $10.000 POUCY x PRO- 1-1 LOC I B AUTOMOBILE LY1dUTY EPP0177578 M/2014 /12015 Ea $1,000,000 BODILY INJURY (PW person) f X I ANY AUTO BODILY INJURY (PeramdeM) f ALL OWNED SCHEDULED AUTOS NONOIANED X HIRED AUTOS X AUTOS PROPERTY DAMAGE rper acdclenl S f C UMBRELLA B IJAEXCESS IX OCCUR SU01442616 H/2014 /l/2015 EACH OCCURRENCE $2,000.000 X AGGREGATE S2,000,000 LAIS CIAIMSMADE OEO I I RETENTIONS $ A WORKERS COMPENSATION 4121092 112014 /112015 X TATU- OTH- AND EMPLOYERS' LIABILITY ANY PROPRIETORMARTNERIEXECUTIVE� E.L. EACH ACCIDENT S500,000 OFFICERNEMBER EXCLUDED? 1Mendatory In NH) N/A E.L. DISEASE - EA EMPLOYE $500 000 EL. DISEASE -POLICY LIMIT f500000 If yee, deembe under DESCRIPTION OF OPERATIONS be. C Stop Gap -Employers Liability -Wyoming 1462568 7 /1/2014 11112015 Each Accident $1.000,000 Each Employee $1.000,000 Aggregate $1,DOD,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES WYch ACORD 101, Additional Rameree ScheduM, 6 nswe epee Is reeu)red) Workers Compensation coverage does not apply to employees who are hired or reside in the States of NO, OH, WA or WY. As required by written contract or written agreement, City of Fort Collins , its officers, agents, and employees, (only as their interest applies as party to the contract) are included as Additional Insured for ongoing operations under the General Liability and Designated Insured under the Automobile Liability. City of Fort Collins PO Box 580 Ft 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 ACORD 25 (2010105) © 1988-2010 ACORD The ACORD name and logo are registered marks of ACORD reserved.