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HomeMy WebLinkAbout497786 MARTIN MARIETTA MATERIALS - INSURANCE CERTIFICATE (16)ACC> CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 09/2712019 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, Sucre 3600 o AK Not: Charlotte, NC 28202 E-MAIL Attn: CA NON-RESIDENT NO.0622889 ADDRESS: CN102458548.1.MMM-GAWX-19-20 INSURER A: ACE American Insurance Company 22667 INSUREDMartinManetta Materials, Inc. INSURERS: Indemndy Ins Co Of North America 43575 Atln Todd Crump INSURER C : ACE Property And Casuatty Ins Co 20699 _ 2710 Wydiff Road INSURER D : PO Box 30013 Ralegh, NC 27622 INSURER E : COVERAGES CERTIFICATE NUMBER: ATL-004816791-13 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 ADD U POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MWDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY HWG71449368 09/3012019 09/30/2020 EACHOCCURRENCE $ 3,000,000 CLAIMS -MADE F OCCUR PREMISE Ea orxirt . $ 50,000 MED EXP (Any one n) $ PERSONAL & ADV INJURY $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 6,000,000 X PRO- JECT PRO ❑ LOC PRODUCTS - COMPIOP AGG $ 6,000,000 It OTHER. A AUTOMOBILE LIABILITY ISAH25285992 09/3012019 09/30/2020 COMBINED SINGLE LIMIT Ea accident $ 5,000,000 BODILY INJURY (Per person) $ ANY AUTO OWNEDS SCHEDULED AUTOONLY AUTOS IXX BODILY INJURY (Per accident) E PROPERTY DAMAGE Per accident $ _ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY X UMBRELLA LIAR X OCCUR G28167581004 09130/2019 09/3UQ020 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 EXCESS LIAR CLAIMS -MADE DED RETENTION $ $ B A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNERtEXECUTIVE a OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A WLRC66042078 (ADS) WLRC6604211A (CA) 09130/2019 0913012020 X SPER ERA E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 E.L. DISEASE -POLICY LIMIT $ 2,000,000 tt yea. describe urMer DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: 2018 CITY OF FORT COLLINS OVERLAY - JOB # 1633272607 CERTIFICATE HOLDER IS ADDITIONAL INSURED UNDER GENERAL LIABILITY AND AUTOMOBILE LIABILITY AS THEIR INTEREST MAY APPEAR, IF REQUIRED BY WRITTEN CONTRACT WITH THE NAMED INSURED, SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICIES, WAIVER OF SUBROGATION IS APPLICABLE WHERE REQUIRED BY WRITTEN CONTRACT AND SUBJECT TO POLICY TERMS AND CONDITIONS. THIS INSURANCE IS PRIMARY AND NON-CONTRIBUTORY OVER ANY EXISTING INSURANCE AND LIMITED TO LIABILITY ARISING OUT OF THE OPERATIONS OF THE NAMED INSURED SUBJECT TO POLICY TERMS AND CONDITIONS WITH RESPECT TO GENERAL LIABILITY AND AUTOMOBILE LIABILITY. CERTIFICATE HOLDER CANCELLATION CITY OF FORT COLLINS - PURCHASING DIV. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 215 N. MASON ST. 2ND FLOOR 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 Stefani ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD