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PIERSON'S CONCRETE CONSTRUCTION CO - INSURANCE CERTIFICATE
M ACORhr CERTIFICATE OF LIABILITY INSURANCE 06/17M/2019YY' 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 1-303-534-4567 INA, Inc. - Colorado Division CONTACT NAM_E____.. PHONE -- - - --- _- IFAX A/C No): _ E-MAIL ADDRESS: denaccounttechs@imacory.com 1705 17th St Ste 100 INSURERS AFFORDING COVERAGE NAIC N INSURERA:PINNACOL ASSUR 41190 Denver, CO 80202 INSURED INSURER B : Pierson's Concrete Construction Co. INSURER C INSURER D_ PO BOX 271248 _ INSURER E : 1 INSURER F: Fort Collins, CO 80527 COVFROnFS CFRTIFICATF NIIMRFR- 56495469 RFVISION NIIMRFR- 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 OF INSURANCE L ADDTYPE I WVn SUBR POLICY NUMBER MMIDDPOLICY EFF POLICY EXP MM/DDNYYY LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $A AG PREM SES(Ea occurrence _________ S MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ GEMLAGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO ❑ LOC JECT OTHER: GENERAL AGGREGATE $ PRODUCTS - COMPIOP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COMBINEDSINGLELIMIT Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ a UMBRELLALIAB EXCESS LU18 HCLAIMS-MADE OCCUR EACH OCCURRENCE S AGGREGATE $ DIED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED7 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 4055614 07/01/19 07/01/20 8 STATUTE I I ERH E.L. EACH ACCIDENT --- $ 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1, 000, 000 i I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schadute, may be attached If more space is required) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1190 AUTHORIZED REPRESENTATIVE Fort Collins , CO 80522 / / USA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD michael.sheinberg 56495469