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HomeMy WebLinkAbout497786 MARTIN MARIETTA MATERIALS - INSURANCE CERTIFICATE,acoR CERTIFICATE OF LIABILITY INSURANCE DATE 09/12/20180/YYYY) �..�- 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 CONTACT Marsh USA Inc. NAME: PHONE 100 North Tryon Street, Suite 3600 LAAC No. Extl: FAX Charlotte, NC 28202 E-MAIL _— Attn: CA NON-RESIDENT NO. 0622889 ADDRESS: CN 102458548-1. MMM-GAWX-18-19 INSURED Martin Marietta Materials. Inc. Attn: Todd Crump 2710 Wycliff Road PO Box30013 Raleigh. NC 27622 INSURER A: ACE American Insurance C: COVERAGES CERTIFICATE NUMBER: ATL-004700079-04 REVISION NUMBER: 22667 43575 20699 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD I WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY HDOG71209659 09/30/2018 09/30/2019 EACH OCCURRENCE $ 3,000,000 J CLAIMS -MADE FK OCCUR DA AGE T6 RENTED FIRMM S ES Ea occurrence) $ 50,000 MED EXP (Any one person) $ __ PERSONAL & ADV INJURY $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 6,000,000 X POLICY PRO JECT ❑ LOC PRODUCTS - COMP/OP AGG $ 6,000,000 $ OTHER A AUTOMOBILE LIABILITY ISAH25272274 09/30/2018 09/30/2019 COMBINED SINGLE LIMIT Ea accident` $ 5.000,000 BODILY INJURY (Per person) X ANY AUTO $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY X UMBRELLA LIAB X OCCUR G28167581003 09130/2018 09I3012019 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ B A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNERlEXECUTIVE OFFICERIMEMBEREXCLUDED? (Mandatory in NH) N/A WLRC6543586A(AOS) WLRC65435901 (CA) 09130/2018 09/3012019 09130/2019 X PER OTH- STATUTE ER E. L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re, 2017 City of Fort Collins Overlay Project - 1633272577 City of Fort Collins is/are additional insured under General Liability and Automobile Liability as their interest may appear, if required by written contract with the named insured, subject to the terms and conditions of the policies. A waiver of subrogation applies under General Liability, Automobile Liability, Workers Compensation, and Umbrella Liability in favor of the certificate holder, if required by written contract with the named insured, subject to the terms and conditions of the policies. General liability and auto liability insurance apply on a primary and non-contributory basis, if required by written contract, and subject to policy terms and conditions. CERTIFICATE HOLDER CANCELLATION City of Fort Collins Purchasing Div. 215 N. Mason St. 2nd Floor 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 of Marsh USA Inc. Annette Stefani © 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD