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Home My WebLink About497786 MARTIN MARIETTA MATERIALS - INSURANCE CERTIFICATE (6)AC CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD/YYYY) o9/12/2018 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 Marsh USA Inc. NAME: PHONE -- - - ---- - FAX 100 North Tryon Street, Suite 3600 C. No. Exq: _ A/c No Charlotte, NC 28202 E-MAIL Attn: CA NON-RESIDENT NO, OB22889 ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: ACE American Insurance Company 22667 CN 102458548 1 MMM-GAXWX-18 INSURED Martin Marietta Materials, Inc. INSURER B : Indemnity Ins Co Of North America 43575 INSURER C : NIA - N/A Attn: Todd Crump 2710 Wycliff Road PO Box 30013 INSURER D : INSURER E : Raleigh, NC 27622 INSURER F : COVERAGES CFRTIFICATF All IMf2F0• ATi nnezaonnc 40 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 WVQPOLICY -- NUMBER MM/DD YYYY) (MM/DD/YYYYI -- - LIMITS A X COMMERCIAL GENERAL LIABILITY X HDOG71209659 09/30/2018 09/30/2019 EACH OCCURRENCE $ 3,000,000 CLAIMS -MADE OCCUR PREMISES (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 PRO- POLICY ❑ N JECT LOC PRODUCTS -COMP/OP AGG 0 $ 6,000,000 $ OTHER A AUTOMOBILE LIABILITY X ISAH25272274 09/30/2018 09/30(2019 COMBINED SINGLE_ LIMIT Ea accident $ 5,000,000 ANY AUTO X BODILY INJURY (Per person) $ OWNED SCHEDULED — AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED rx NON -OWNED AUTOS ONLY AUTOS ONLY X PROPERTY DAMAGE Per accident $ UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ - AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED RETENTION $ $ B WORKERS COMPENSATION WLRC6543586A(AOS) 09/30/2019 X PER OTH- A AND EMPLOYERS' LIABILITY Y/N STATUTE ER E.L. EACH ACCIDENT $ 2,000,000 ANYPROPRIETOR/PARTNER/EXECUTIVE WLRC65435901 (CA) 09/30/2018 09/30/2019 OFFICER/MEMBER EXCLUDED? N N/A E L DISEASE - EA EMPLOYEE $ 2,000,000 (Mandatory in NH) It yes, describe under E.L. DISEASE - POLICY LIMIT _ $ 2,000,000 DESCRIPTION OF OPERATIONS below I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re. 7377 Asphalt Supply Renewal. City of Fort Collins - Purchasing Division is additional insured (except Workers' Compensation) 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 Workers Compensation in favor of the certificate holder, if required by written contract with the named insured, subject to the terms and conditions of the policies. %,AV0,r_LLA I IUIV City of Fort Collins - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Purchasing Division THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Gerry Paul ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Annette Stefani ,_L"5,,,-,,,,,",66_ _'L U 15873-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD