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HomeMy WebLinkAbout497786 MARTIN MARIETTA MATERIALS - INSURANCE CERTIFICATE (3)ACORO� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 09/12/2018 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 CONTACT NAME: Marsh USA Inc. _ _ PHONE FAX 100 North Tryon Street, Suite 3600 Arc No : E-MAIL Charlotte, NC 28202 Attn: CA NON-RESIDENT NO.OB22889 ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: ACE American Insurance Company 22667 CN102458548-1.MMM-GAWX-18-19 INSURED Martin Marietta Materials, Inc. INSURER B : Indemnity Ins Co Of North America 43575 — INSURER C : ACE Property And Casualty Ins Co 20699 Attn: Todd Crump 2710 Wycliff Road PO Box 30013 INSURER D : Raleigh, NC 27622 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: ATL-004748119-04 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. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY X HDOG71209659 09/30/2018 09/30/2019 EACH OCCURRENCE $ 3,000,000 CLAIMS-MADEFxl DAMAGE TO RENTED 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 POLICY PRO- JECT LOC X PRODUCTS -COMP/OP AGG $ 6,000,000 $ OTHER A AUTOMOBILE _ LIABILITY X ISAH25272274 09/30/2018 09/30/2019 COMBINED SINGLE LIMIT Ea accident $ 5,0W000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY X UMBRELLALIAB X OCCUR G28167581003 09/30/2018 09/30/2019 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 EXCESS LIAB CLAIMS -MADE DID RETENTION $ $ B A WORKERS COMPENSATION AND EMPLOYERSLIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICE RIME M BER EXCLUDED? ❑PI (Mandatory in NH) NIA WLRC6543586A(ADS) WLRC65435901 (CA) 09/30/2018 09/3012019 09/30/2019 X PER OTH- ER' STATUTE 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 I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: 2017 / 2018 Snow and Ice Removal Project Certificate holder is 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, Waiver of subrogation is applicable where required by written contract and subject to policy terms and conditions. This insurance is primary and non-contributory over any existing insurance and limited to liability arising out of the operations of the named insured subject to policy terms and conditions with respect to General Liability and Automobile Liability. lha:AI17LillyG\I;0:Lei 011 hG1.LyaAw_ULei 0 City of Fort Collins 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 e,-r+✓cc' -_ '—L w ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD