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WELHAM CONCRETE INC - INSURANCE CERTIFICATE (5)
® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDYVVY) ACORN L � 3/26/2015 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 Vetwork Insurance Services,LLC 5261 S. Quebec St. Suite 100 3reenwood Village CO 80111 INSURED WELHA31 Welham Concrete, Inc. 9004 Eldorado Ave. Frederick CO 80504 COVERAGES CERTIFICATE NUMBER: 467416320 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. WSR LTR TYPE OF INSURANCE INSR POLICY NUMBER POLICY EFF MMIDDIYYYV POLICY EXP LIMITS MMIDDIYVW C GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X PD Ded: 10,000 SVO1412823 /22/2014 /22/2015 EACH OCCURRENCE $1,000.000 AMAX PR MISES Me =i ence $100,000 MED EXP (Any one person) $5 000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GENL AGGREGATE LIMIT APPLIES PER: POLICY I^ �- LOC PRODUCTS - COMP/OP AGG $2,000,000 1$ AUTOMOBILE LIABILITY ANY AUTO AALL UTOS OWNED SCHHOEDUN ED MON-OWNED HIRED AUTOS X AUTOS Med Pay 5000 BA8647897 22(2014 /22(2015 UUMEa UIN1,L) SINGLE LIMIT nt) $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Peraccident $ X $ UMBRELLA UAB EXCESSLWB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DIED RETENTION$ 1 $ WORKERS COMPENSATION AND EMPLOYERS'LWBILrrY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFRCER/MEMBER EXCLUDED? (Mandatory in NH) IF yes, describe under DESCRIPTION OF OPERATIONS below NIA 4162597 1/2015 1/2016 X WCSLIMIT OR $1,000,000 $1,000.000 $1,000,000 E.L. EACH ACCIDENT E.L. DISEASE- EA EMPLOYEE E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Ft Collins is named as additional insured for General Liability. GtK I It -RA City of Fort Collins PO Box 580 Fort Collins CO 80522 ACORD 25 (2010/05) 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 R ESENTATIVE / is--'r (//': ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD