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Home My WebLink About504618 CONCRETE EXPRESS - INSURANCE CERTIFICATE (2)Client#: 51862 8CONCEXP ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATEDIYYYY) an9/20nola 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 Willis of Colorado, Inc. 2000 South Colorado Boulevard Tower II, Suite 900 Denver, CO 80222 CONTACT NAME: PRONE 303 722-7776 FAX 303-722-8862 PANNo Ezt: A/C No: E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAICd INSURER A: Travelers Property Casualty Corn 36161 INSURED Concrete Express, Inc. 2027 West Colfax Ave. INSURERS: TRAVELERS CASUALTY AND SURETY C 31194 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. IN RR OF INSURANCE ADDTYPE NSRLSUBR MD POLICY NUMBER MM/DDY EFF MM/DDV UP LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F7x OCCUR X CG D2 46 08 05 X VTC2JC05643B612TIL 5/01/2014 05/01/2015 EACH $1000 000 ��OCCURRENCE PAEMISES Es .eeNTEDence $300OOO MED UP (Any one person) $5 000 PERSONAL S ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY PRO LOC PRODUCTS-COMP/OP AGO $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIREDAUTOS X NON -OWNED VTC2JCAP5643B624T1 5/01/2014 05/01/201 COMBINED SINGLE LIMIT Ea accideral $1,000,000 X BODILY INJURY (Per person) $ 1AUTOS BODILY INJURY Per accident)$ ( X PROPERTYDAMAGE Peraccitlem $ A X UMBRELLA LIAB EXCESS LIAR X OCCUR CLAIMS -MADE ZUP13N4919114NF 5/01/2014 05/01/2015 EACH OCCURRENCE $10000000 AGGREGATE $ I or 0 0 or OOO DED I X RETENTION $$1 O 000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, tlesalbe under DESCRIPTION OF OPERATIONS below N I A VTC2KUB4B88054014 0510112014 05/01/201 X WCSTATu- OTH- E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE 0,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) Project Description: Grade Separated Crossing at NRRC Project Number: Bid No. 7535 The following are Additional Insureds as respects General Liability and Umbrella Liability only if required by written contract (See Attached Descriptions) City of Fort Collins 300 Laporte Avenue 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 ACORD 25 (2010/05) 1 of 2 #S1095133/M1095079 lJ ltfbt lU AUUKU UUKPUKA I IUN. All rights reserved. The ACORD name and logo are registered marks of ACORD 8ALIN DESCRIPTIONS (Continued from Page 1) and coverage applies only as respects work performed by the Insured for the Additional 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. Additional Insureds: City of Fort Collins and the Colorado Department of Transportation The General Liability coverage is Primary per the policy terms & conditions only if required by written contract. The Workers' Compensation and General Liability 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. JAbl I IA ZJ.J (ZUIU/Ub) Z of Z #51095133/M7095079