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Home My WebLink About504618 CONCRETE EXPRESS - INSURANCE CERTIFICATEClient#: 51862 BCONCEXP ACORD.. CERTIFICATE OF LIABILITY INSURANCE DTE 4/29/2/DDA'VYY) 129/2014 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 endorsement(s). PRODUCER CONTACT NAME: Willis of Colorado, Inc. PHONE 303 722-7776 FAX 303-722-8862 Ezt: AIC, No 2000 South Colorado Boulevard E-MAIL Tower II, Suite 900 ADDRESS: Denver, CO SO222 INSURERS) AFFORDING COVERAGE NAIL 0 INSURER A, Travelers Property Casualty Cont 36161 INSURED INSURERB: TRAVELERS CASUALTY AND SURETY C 31194 Concrete Express, Inc. 2027 West Colfax Ave. INSURER c Denver, CO 80204 INSURER D: INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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 rypE OF INSURANCE ADDLSUB INSR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X CG D2 46 08 05 X VTC2JC05643B612TIL 5101I201405/011201 E OCCURRENCE $1000000 oEoACH PREMISES ERENTED nce $300OOO MED EXP (Any one person) $5 OOO PERSONAL $ ADV INJURY $1 000,000 GENERAL AGGREGATE s2,000,000 GENL AGGREGATE LIMIT APPLIES PER: POLICY PRO LOG JECT PRODUCTS - COMP/OP AGG $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIREDAUTOS X NON -OWNED AUTOS VTC2JCAP5643B624T1 5/01/2014 05/01/2015 EOM�BINdEEDISINGLELIMIT $1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY Per accident ( ) $ X PROPERTY DAMAGE Per acddent $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE ZUP13N4919114NF 5101/2014 0510112015 EACH OCCURRENCE $10000000 AGGREGATE $10 000 000 DED I X I RETENTION$$10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, deserlhe under DESCRIPTION OF OPERATIONS below NIA VTC2KUB4B88054014 5/01/2014 05/01/2015 - X WCsTATu- OTH- E.L. EACH ACCIDENT $1 000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Project Description: MAX Project Project Number: WC#305219OM8-01 The following are Additional Insureds as respects General Liability and Umbrella Liability only if required by written contract and coverage applies only as respects work performed by the Insured for the Additional (See Attached Descriptions) City of Fort Collins Purchasing Division 215 N Mason St 2nd Floor 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 0) 1ARR-201D ACrTRn OrTRPnRATInIJ All rinhla ACORD 25 (2010105) 1 of 2 The ACORD name and logo are registered marks of ACORD #S1095135/M1095079 BALIN DESCRIPTIONS (Continued from Page 1) 1 Insureds. All coverage terms, conditions and exclusions of the policy apply. The following are Additional Insureds on the Automobile Liability only to the extent they meet the definition of an insured in the policy, which provides in pertinent part that an insured includes anyone liable for the conduct of an insured but only to the extent of that liability. All coverage terms, conditions and exclusions of the policy apply. Consult the policy to determine the extent of coverage, if any. Insureds: City of Fort Collins, State of Colorado and Burlington Northern Santa Fe Railroad (BNSF) The General Liability, Auto Liabiity and Umbrella coverage is Primary per the policy terms & conditions only if required by written contract. The Workers' Compensation, Auto Liability, General Liability and Umbrella policies include a Waiver of Subrogation in favor of the Additional Insureds only if required by written contract. The Additional Insured endorsement which is referenced above under "Type of Insurance -General Liability" is attached. JAb11 1A Zb.3 (ZU1U/US) Z of Z #S10951351M1095079