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MARROU CONCRETE INC - INSURANCE CERTIFICATE
A�ROr CERTIFICATE OF LIABILITY INSURANCE DATEIMNUOD/19 06/28y2019 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 endorsements . PRODUCER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 CONTACT NAME: CLIENT CONTACT CENTER PHONE (A/C, No Ext : 888-333-4949 Fayc No : 507-446-4664 ADDRESS: CLIENTCONTACTCENTER FEDINS.COM OWATONNA, MN 55060 INSURER(S) AFFORDING COVERAGE NAIL # INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 177-911-5 INSURER 8: MARROU CONCRETE, INC. INSURER C: 625 SHERRY DR INSURER D: FORT COLLINS, CO 80524-8513 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 13 REVISION NUMBER: 0 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 7ypE OF INSURANCE LTR ADDL INSR SUBR WVD PO ICY NUMBER POLICY EFF MMIDDIYYYV POLICY EXP MMIDDIYYYV LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE � OCCUR Y N 9369166 07/01/2019 07/01/2020 EACH OCCURRENCE $1 ,000,000 DAMAGE PRTED EMISES OER oIccurrence $100,000 MED EXP (Any one person) EXCLUDED GEN'L X PERSONAL& ADV INJURY $1 000 000 AGGREGATE LIMIT APPLIES PER. POLICY ❑ jECT LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMPIOP AGO $2,000,000 A AUTOMOBILE X LIABILITY ANY AUTO SCHEDULED OWNED AUTOS ONLY AUTOS HIRED AUTOS ONLY NON -OWNED AUTOS ONLY N N 9369166 07/01/2019 07/01/2020 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) BODILY INJURY (Per accident) - PROPERTY DAMAGE Per eccidmt A X UMBRELLA LIAR EXCESS LIAR X OCCUR CLAIMS -MADE N N 9369167 07/01/2019 07/01/2020 EACH OCCURRENCE $2,000,000 AGGREGATE $2,000,000 DED I RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETORIPARTNEWEXECUTIVE f—� OFFICER MEMBER EXCLUDED' (Mandatory in NH) It yes, describe under DESCRIPTION OF OPERATIONS below N I A PER STATUTE OTH- ER E.L. EACH ACCIDENT EL.DISEASE - EA EMPLOYEE E.L DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be IMIlled it more space M required) SEE ATTACHED PAGE CERTIFICATE HOLDER CANCELLATION 177-911-5 13 0 CITY OF FORT COLLINS ENGINEERING DEPT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 281 N COLLEGE AVE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN FORT COLLINS, CO 80524-2404 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved- ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD