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HomeMy WebLinkAboutWESTERN CONCRETE CONTRACTORS INC - INSURANCE CERTIFICATE (2)-`� OR" CERTIFICATE OF LIABILITY INSURANCE DATE (MM,DDIYYYY) 9/3/2019 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). CONTCT PRODUCER NAME: IMA Denver Team IMA, Inc - Colorado Division PHONE 303-534 4567 (Ai o: 1705 17th Street, Suite 100 E-MAIL Denver CO 80202 A DRESS: DenAccountTech5ftmecorp.com 5 INSURED Western Concrete Contractors, Inc. 3401 Quebec Street, Suite 9105 Denver CO 80207 COVERAGES CERTIFICATE NUMBER: 1935448097 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' TYPE OF INSURANCE AObL,SU - POLICV EFF - - POLICY EXP - f LTRI W POLICY NUMBER MMlDD,YYYY MMIDDIYV LIMITS A X CWWRCIAL GENERAL LIABILITY OTC08D43112ACOF19 9/1/2019 9/1/2020 EACH OCCURRENCE $1.000.000 $300,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED L PREMISES Ea occurrence) X ' SD Deductible_ IEXP Any oneperson) f 5,000 $ 1.000.00 . PERSONAL f ADV INJURY GEWL AGGREGATE LIMIT APPLIES PER: $2,000,000 GENERAL AGGREGATE r� PRO- i— POLICY JECT I— LOC — PRODUCTS - COMP,'OP AGO _ f 2,000,0D0 f OTHER: B AUTOMOBILE LIABILITY DT8104N018438PHX19 911/2019 9/112021 COMBINED SINGLE LIMIT _ IEa. accident) f1.D00.000 _ $ X ANY AUTO BODILY INJURY (Per person) OWNEDONLY AUTOS SCHEDULED AUTOS BODILY INJURY (Par Ilxldant) S f X HIRED i X NON -OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY ,. lPerp ant S C X UMBRELLA LIAB '4 X I OCCUR EXCESS LAID , CLAIMS -MADE CUP8J2479881926 9/1/2019 9/1/2020 EACH OCCURRENCE AGGREGATE $2.000.000 $2.000,D00 DED X ' RETENTION S,,ln non — f �'i D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETORIPARTNEPoEXECUTIVE YNN Fr 4043600 9112018 9/12020 IX i STATUTE ER — E.L. EACH ACCIDENT f 1,0o0,000 OFFICERIMEMSEREXCLUDED? (Mandatory in NH) NIA�I F. L. DISEASE - EA EMPLOYEE $1,000.000 $ 1,000,000 If yes, doscnbe under DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT B Automobile Physical Damage Coverage DT8104NO16438PHX19 9;V2019 9/1/2020 Deductibles: Collision Comprehensive 1.000 1,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be al lached if more space is required) Leased 8 Rented Equipment Coverage: Policy #:QT6608F331026TIL19 Effective Dates: 09/0112019 - 09/01/2020 Insurer C: See Above $750,000 Limit: $1,000 Deductible Contractors Equipment Coverage with Deductible Wording Policy #:QT6608F331026TIL19 Effective Dates. 09/01/2019 - 09/01/2020 Insurer C: See Above $5,068,842 Limit; $1,000 Deductible Deductible is $10,000 for Equipment Valued over $80.000 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. 281 N. College Ave; P O. Box 580 AUTHORIZED REPRESENTATIVE Fort Collins CO 80526-0000 USA /a © 1988.2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 2' of 2 i0863