HomeMy WebLinkAboutPIERSON'S CONCRETE CONSTRUCTION CO - INSURANCE CERTIFICATE (2)ACCORDr CERTIFICAT OF LIABILITY INSURANCE DATE
A E(MWO2oYY)
6124120
THIS CERTIFICATE IS ISSUED AS A MATTER 'OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON'' THE`CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGA VELY 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:. It the certificate holder is an ADDITIONAL INSURED, the pollcy(ies)'must have ADDITIONAL INSURED. provisions or be endorsed.
It SUBROGATION IS WAIVED, subject to the terms and:conditions of the policy; certain policies may require:an endorsement. A statement on
this certificate ddes.not.confer.rights to the certificate holder in lieu of such endorsement(s).
IMA,nc NAMEr Team
7nc. - Colorado Division PHONE
170 I-4567 5 17tFi Street, Suite 100 : IMA Denver 303-534A/c No):
Pierson's Concrete Construction Co.
PO Box 271248
Fort Collins CO 80527
Cincinnati Specialty UW;Ins.Company 13037
Ehi to ers.Mutual Casualty Company 21415
Pinnacol Assurance 41190
United Specialty Insurance Comnanv 12537
THIS IS -TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED
INDICATED. NOTWITHSTANDING ANY REQUIREMENT; TERMI'OR
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN
BELOW HAVE BEENASSUED TO THE INSURED NAMED ABOVE:FOR THE. POLICY PERIOD
CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS;
MAY HAVE BEEN "REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OFINSURANCE
ODL
B
POLICY NUMBER
". PAAS DD�IYEYYIF
MMIDDYYYYY
-LI&UTS.
A
-
X
COMMERCIALGENERAL LIABILITY
CLAIMS -MADE 7 OCCUR
811PDDed:WOOD
CSU01.30880.
'711/2026
I
_..
7/112021
...
EACHOCCURRENCE. -
$1,000,000.
PREMISES En occurrence
$100,000
X
MED EXP (Any.one person)
$5,000
PERSONAL & ADV:INJURY
$1.000,000
GEN'L AIGOREGATE LIMIT APPLIES PER:
POLICY X jECT LOC
OTHER:
GENERAL. AGGREGATE.
$ 2i000,000
PRODUCTS - COMP/OP AGG
$2;000,000
$
8
AUTOMOBILELIABILITY
X. ANY -AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
X: HIRED. .x NOWOWNED
- - - 1 AUTOS ONLY AUTOS ONLY
._. _ ..
6X18950
7MN2'0
71V2021
DMBINF�)SINGLELIMIT
a SINGLE
"$1,000.000
BODILY INJU RI',(Per. person)
_
$
BODILY.INJURY(Pen accltlentj
$
PROPERTY AMAGEE:
Per scoldent '
$
$.
D
UMBRELLALIAB
I EXCESS LIAB I
X
IOCCUR
I CLAIMS -MADE
BTN2096
85
7/112020.
7/1/2021
EACHOCCURRENCE
$2:000.000
X
AGGREGATE
$2,000,000
DED 1 .1 -.RETENTION.$.
$
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANYPROPRIETORIPARTNERIEXECUTIVE YIN
OFFICER44EMSEREXCLUE a'
(Mandatory In NH)
It yes, describe under
DESCRIPTION'OF OPERATIONS below
N I A
4055614
7/1/2020
711/2021
X I STATUTE [ERH
E.L. EACHACCIDENT_
$1.000,000
E.L. DISEASE -,EA EMPLOYEE
$1,000,000
E.L. DISEASE'- POLICY. LIMIT
$1 000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD.101, Additionel
Remedte Schedule, my be attached II more space Is regaled)
1%C0T1=IL`ATC Ynl n=O r1AAICFI-I ATInIJ.
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.
PO Box 1190
AUTHORIZED REPRESENTATIVE
Fort. Collins CO 60068-0522
USA
LVIUbt1+ZUT0 AL;VKU cunrvnA I wrv. An ngnis reserved:
ACORD.25 (2016103) The ACORD n me and logo are, registered marks of ACORD
2' of 2 17659