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Home My WebLink About497786 MARTIN MARIETTA MATERIALS - INSURANCE CERTIFICATE (13)® CERTIFICATE OF LIABILITY INSURANCE DATE (MMDD/YYYY) 09/27/2C 19 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 Marsh USA Inc. 100 North Tryon Street, Suite 3600 Charlotte, NC 28202 Attn: CA NON-RESIDENT NO.0822889 CN102458548-1.~GAWX-19-20 NOC INSURED Martin Marietta Materials, Inc. Attn. Todd Crump 2710 Wycliff Road PO Box 30013 Ralegh, NC 27622 NAME: PHONE FAX AIC No E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: ACE American Insurance Company 22667 INSURER B : Indemnity Ins Co Of North America 43575 INSURER c : ACE Property And Casualty Ins Co 20699 INSURER D : INSURER E : INSURER F : rnvcwer.Fc r FRTIFICATF NIIMBFR: ATL-004700792-12 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. MSR TR OF INSURANCE ADDLTYPE iNgn SUER POLICYNUMBER EFF MMDDPOLICY/YYYY P MMDD(YY LIMITS A X COMMERCIAL GENERAL LIABILITY HDOG71448368 09/30/2019 09130/2020 EACH OCCURRENCE $ 3,000,000 CLAIMS -MADE [11 OCCUR DAMAGE TO RENTED PREMISES Ea occurrence S 50,000 MED EXP (Any oneperson) $ PERSONAL is ADV INJURY S 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE S 6,000,000 PRODUCTS SPOLICY❑PRO- 6,000,000 X JECT❑LOC S OTHER: A AUTOMOBILE LIABILITY ISAH25285992 09/30/2019 09130/2020 COMBINED SINGLE LIMIT Ea accident $ 5,000,000 BODILY INJURY (Per parson) S ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED X NON -OWNED XI AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ $ X UMBRELLALIAe X OCCUR G28167581004 09/30/2019 09/30/2020 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 EXCESS UAB CLAIMS -MADE DED RETENTION $ $ B A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? a (Mandatory in NH) NIA WLRC66042078 (AOS) WLRC6604211A (CA) 09/30/2019 09130/2020 09/30/2020 X PER TH- STATUTE ER E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE S 2,000,000 E.L. DISEASE -POLICY LIMIT $ 2,000,000 if yes, desuibe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) Certificete holder is additional insured under General Liability and Automobile Liability as their interest may appear, if required by written contract with (he named insured, subject to the terms and conditions of the policies. A waiver of subrogation applies under General liability, Automobile Liability, and Workers Compensation in favor of the ceNficate holder, if required by wntten contract with the named insured, subject to the terms and conditions of the policies. General liability and auto liability insurance apply on a primary and noncontributory basis, if required by written contract, and subject to policy terms and conditions. Please see additional page for Notice of Cancellation information r iuA 1 c mULUCrt City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE P.O. Box 580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Fort Collins. CO 80522 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Annette StefaniL.. iLcz-xzr-+ lJ T9t1i1-LUTb HI.VKU VVKI'VRA I IUIY. All rll911l5 ICbeFvwu. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD