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Home My WebLink About498349 BANNER CONCRETE LLC - INSURANCE CERTIFICATE (3)OP ID: BA ATECERTIFICATE OF LIABILITY INSURANCE O02'Mw3/D02501'S 02/1 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policylies) 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 PRODUCER JT 200 wsuas0 Banner Concrete, LLC IMUMRA: Liberty Mutual Group 41785 1408 Steeple Chase Or imu. s: PlnnRcol Assurance Cc 41190 Fort Collins, CO 80524 IxsuMR c: 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 POUCY 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 TERM, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MT 1LE TYPE OF INBVMMOB FAR cal POLICY NUMBER OTIC LIMITS A OEMEML LABNR X COMMEMMGENEW LMBILItt CWMSdNOE O OCCUR X Limited Pollution BK51666371437 BKSISS6371437 03101/2015 03/01/2015 03/01/2010 0310112016 EACH OCCURRENCE S 1,000,000 DAMACEIGRENIMU P WSEs A S 300,00 MED UP M — $ 15,000 PERSONAL S ARV INJURY s 1.000,00 GENERALAGGIREGTE $ 2,000,000 GEN-L AGGREGATE POLICY LIMIT APPUES PER: PR LOC PRODUCTS - COMPIOP Ads S 2.000,000, Pollution S 50,00 A AInOMO"Le "'war" ,wY AuTo ALLONMEDAUTOS SCHEDULED AUTOS HIRED AInOS rvoN.owaeOAmos BA1566065194 02122J2015 02/22/2018 COMBINED SINGLE LAST (Eddesce l BODILY INJURY IP>MFm) S 1,000,0 S X -- BODILYIWUW(1 —ISM) S PROPERTY DAMAGE (PER ACCIDENT) S X X MBDICALPAY S 5,0 UMRXM s 1,000,00 UMBRELLA DAN .DUN I.I.I.CMM:.E UOCU A EACH,OCCURRENCE i AGGREGATE B DEOUCTIBLE RETENTION 4 f B B WOMERS COMPENSAMN ANDEWLOYERB'LIANDrY ANY PROPUFTORNARTNER.ECOTNE YIN OFFICERNEMBER ECLUOED, 'Mu, Min rvm It yw 0ean"Ee unn.r DESLRIPTIONOFOPERATIONS bNox NIA 4146286 0310112076 O3I01l2018 WC mA'N- OTH- EL EACHACCIDENT S 1,DOD,DO E.L. DISEASE -EA EMPLOYEE S 1,000,00 E.L. DISEASE-POUCYUMIT - S 1,000,00 DESCRIPTION OF OPERATORS I LOCATIONS I VEHICLES Usich ADDED 101, Additional RFmFMe Schedule, 11 men yw IFrequlM) If re uire� b�r written contract or written agreement, the certificate hold Is nc utied as additional insured 1`0 ongoing operations under general liability and automobile liability. CERTIFICATE HOLDER CANCELLATION CTYFC-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Fort Collins Risk Management 215 N. Mason AUTHORIZED REPROSENTATNB Fort Collins, CO 80524 ®1988.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD