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HomeMy WebLinkAbout241623 AGGREGATE INDUSTRIES - INSURANCE CERTIFICATEl ® A�dRO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/24/2018 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 have ADDITIONAL INSURED provisions or 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 Aon Risk Services Southwest, Inc. Houston TX Office CONTACT NAME: PHONE (866) 283-7122 FAx (800) 363-0105 (A/C. No. Ext): (A/C. No.): E-MAIL ADDRESS: 5555 San Felipe Suite 1500 Houston TX 77056 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: ACE American Insurance Company 22667 Aqqreqate Industries Management, Inc. INSURERB: Indemnity Insurance Co of North America 43575 Dull Ann Arbor Road Dundee MI 48131 USA INSURERC: ACE Fire Underwriters Insurance Co. 20702 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570073179648 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. Limits shown are as requested TR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYYEXP MM DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY HDOG71212221 1 iU/Ui/2U'9 EACH OCCURRENCE $2,000,000 CLAIMS -MADE X❑ OCCUR DAMAGERENTED PREMISES Ea occuuence $2 , 000 , 000 MED EXP (Any one person) $ 5 , 000 PERSONAL & ADV INJURY $2 , 000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $10,000,000 X POLICY ❑ PRO ❑ LOC JECT PRODUCTS - COMP/OP AGG $4,000,000 OTHER. A AUTOMOBILE LIABILITY ISA-H25272584 101011201810/01/2019 COMBINED SINGLE LIMIT Ea accident $5,000,000 BODILY INJURY ( Per person) X ANYAUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGE Per accident UMBRELLA LIAB EACH OCCURRENCE AGGREGATE EXCESS LIAB HOCCUR CLAIMS -MADE DED I RETENTION B C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A WLRC65436115 WC (ADS) SCFC6543619A WC (WI) 10/01/2018 10/01/2018 10/01/2019 10/01/2019 X1 PER OTH- STATUTE ER E.L. EACH ACCIDENT $1 , 000 , 000 E.L. DISEASE -EA EMPLOYEE $1, 000 , 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1 , 000, 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) insured is self -insured on physical damage for all owned, leased and rented autos. RE: All projects in and near the City of Fort Collins, CO. City of Fort Collins is included as Additional Insured as required by written contract, but limited to the operations of the Insured under said contract, per the applicable endorsement with respect to the General Liability and Automobile Liability policies. CERTIFICATE HOLDER CANCELLATION 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 AUTHORIZED REPRESENTATIVE Attn: Purchasing Department PO Box Fort 580y Collins CO 80522 USA c?��fC r�ctr�aea cJ�urD��Jna d m V co 0) n 0 0 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000035837 LOC #: A ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY NAMED INSURED Aon Risk Services Southwest, Inc. Aggregate Industries Management, Inc. POLICY NUMBER See Certificate Number: 570073179648 CARRIER NAIC CODE See Certificate Number: 570073179648 EFFECTIVE DATE. ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Additional Named Insureds Aggregate Industries Management, Inc. Tiger Delivery LLC Aggregate Industries Land Company, Inc. Aggregate Industries - Northeast Region, Inc. Aggregate Industries - WCR, Inc. Aggregate Industries - MWR, Inc. Kost, Inc. Meyer Material Company, LLC Bardon, Inc. D/B/A Aggregate Industries - MAR Tiger Minimix, Inc. Aggregate Industries - SWR, Inc. D/B/A Frehner Construction Lattimore Materials Corp. Lordstown Construction Recovery LLC Redland Quarries NY Inc. Lafarge Aggregates Illinois Inc. Fredonia valley Railroad, Inc. Tarrant Concrete Co., Inc. The ACORD name and logo are registered marks of ACORD