HomeMy WebLinkAbout120116 BESTWAY CONCRETE & AGGREGATE - INSURANCE CERTIFICATEBESTW-2 OP ID: MMZ
ACORO CERTIFICATE OF LIABILITY INSURANCE
2/255
D02/25ATE //2 Y015
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
CRS/Surescape Ins. Services
6600 E. Hampden Ave.
Denver, CO 80224
Erik E. Ulibarri
CONTACT
Alex Rothey
NAMPHONE
_
3039957800 FAX
A/C No - - A/c No: 303-757-7719
AE&A": arothey@cmdenver.com
INSURERS AFFORDING COVERAGE
NAIC 0
INSURER A:The Travelers Companies
INSURED Bestway Concrete 8: Aggregate
INSURERS: Plnnacol Assurance
Ed Foster
301 S. Centennial Dr.
INsuRERc:
Milliken, CO 80543
INSURERD:
INSURER E :
INSURER F :
CnVFRAGFS CFRTIFICATF NIINIRFR- RFVIAIAN NI INIRFR-
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.
INSR
LTR
T INSURANCE
ADOL
U
POLICYNUMBER
POLICY EFF
MM/DD
POLICY EXP
MWD
LIMITS
A
X
COMMERCIAL GENERALuAmLITY
CLAIMS -MADE a OCCUR
Y-630-5F600378
03/01/2016
03/01/2016
EACH OCCURRENCE
$ 1,000,00
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 100,00
MED EXP (Any one person)
$ 5,00
PERSONAL$ ADV INJURY
$ 1,000,00
GENL AGGREGATE LIMIT APPLIES PER:
PRO-
JECT LOG
X POLICY1:1 ❑
OTHER.
GENERAL AGGREGATE
S 2,000,00
PRODUCTS-COMP/OP AGG
$ 2,000,00
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS TOSHIRED AUTOS X NON-OW14ED
AUTOS
Y-810-5F600378
0310112015
03/0112016
COMBINED SINGLE LIMIT
Ea accident)$
1,000,00
BODILY INJURY (Per person)
$
JX
BODILY INJURY (Per ecdderd)
$AU
PROPERTY DAMAGE
Per accident
$
$
A
J(
UMBRELLAL"
EXCESS LIM
X
OCCUR
CLAIMS -MADE
YSM-CUP-5F600378
03101/2015
03/01/2016
EACH OCCURRENCE
$ 2,000,00
AGGREGATE
$ 2,000,00
DIED I X I RETENTION$ 10,000
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N
OFFICER/MEMBER EXCLUDED? ❑
(Mandatory In NMI
H Yes, describe under
DESCRIPTION OF OPERATIONS below
N/A
026925
03/01/2015
03/0112016
I
X I PER OTH-
TATUTE ER
E.L. EACH ACCIDENT
$ 500,00
E.L. DISEASE - EA EMPLOYEE
S 600,00
E.L. DISEASE - POLICY LIMIT
$ 500,00
A
Leased/Rent Equip
Y-630-5F600378
I
03101/2015
03/0112016
Limit 250,00
Ded 5,00
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be a techeo if more space is required)
All policy terms, conditions and exclusions apply.
CFRTIFICATF HnI nFR r:Aur ri I ATInA1
CITYFOR
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins
ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 580
AUTHORIZED REPRESENTATIVE
Fort Collins, CO 80522
Qn ' 1
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