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HomeMy WebLinkAboutRMS CONCRETE INC - INSURANCE CERTIFICATE (3)RMSCONC-01 SONIB °AT/7/2D"YYY' 10d/2019 CERTIFICATE OF LIABILITY INSURANCE 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 - C NTACT - - - - Mountain West Insurance- Glenwood PO Box 1576 Glenwood Springs, CO 81602 PHONE` FAX .,. ac, No, Est : 970 945-9111 AIC, No : 970 945-2350 Ei A[IL M RE INSURERS AFFORDING COVERAGE NAIC p'. . INSURER A: Cincinnati Insurance Company 10617 INSURED INSURER B : Plnnacol. Assurance 41.190 INSURER C:Admiral Insurance Company 24856 RMS Concrete Inc INSURER 0 : PO Box 670 Glenwood Springs, CO 81602 INSURER E INSURER F.: C(1V1FRAR1FR CFRTIFICATF NI]MRFR• 1 DGVISIr1N NIIIMRCR- 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 CONTRACTOR 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 ADDLINSO SUBRWVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X EPP0497622/EBA0497622 7/26/2019 7/26/2020 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED PREMISES fEa occurrence) $ 5001000 MED EXP (Any one erson 10,000 PERSONAL B ADV INJURY 11000,000 GEWL AGGREGATE LIMIT APPLIES PER: POLICY Fxl M& FI LOC .OTHER: GENERAL AGGREGATE 2,000,000 PRODUCTS-COMP/OPAGG 21000,000 A AUTOMOBILE LIABILITY - ANY AUTO OWNED 'SCHEDULED AUTOS ONLY AUTNOOSWNEp AUTOS ONLY AUOTOS ONLY EPP04976221EBA0497622 7/26/2019 7/26/2026 COMBINED SINGLE LIMIT 100,000 X BODILY INJURY Per person) BODILY. INJURY Peraccidwt PeOr aEGtl�t AMAGE A UMBRELLA LIAB EXCESSLUAB X. OCCUR CLAIMS -MADE EPP0497622/EBA0497622 7/26/2019 7/26/2020 EACH OCCURRENCE 5,000,000 X AGGREGATE $ 5,000,000 DED X RETENTION $ 0 B WORKERS COMPENSATION AND EMPLOYERS' -LIABILITY Y I NER ANY PROPRIETOR/PARTNEWEXECUTIVE pFFICERIMEM R EXCLUDED? a W..'Cd oryIn�iEFI) It describe under DE SCRIPT ION OF OPERATIONS below N l A 4026391 1%1/2019 _ 1H@O2O X PER- X OTH- E.L. EACH ACCIDENT 1.,000,000 E.L. DISEASE - EA EMPLOYE 1,000,000 E.L. DISEASE- POLICY LIMB '1,000,000 A C Equipment Floater Pollution EPP0497622/EBA0497622 FEIECC2204304 7/26/2019 10/2/2019 7/26/2020 10/2/2020 Leased/Rented Eqpmnt Per Claim 25,000 I.000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addidonal Remarks Schedule, may be attached if more ace Is required)) RE: Contractor's License. Holder is Included as Additional Insured under General Liability only and only ine respect to ongoing operations performed by Insured on behalf of holder as required by written contract City Of Fort Collins PO Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/031 ©1988-2015 ACORD The ACORD name and logo are registered marks of ACORD All riahts reserved