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Home My WebLink About497786 MARTIN MARIETTA MATERIALS - INSURANCE CERTIFICATE (19)DATE (MM/DD/YYYY) ACOR[a CERTIFICATE OF LIABILITY INSURANCE 09/24/2015 lit . 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 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 NAME: Marsh USA Inc. PHONE FAX 100 North Tryon Street, Suite 3600 WC, No A19 No): Charlotte, NC 28202 E-MAIL Attn: CA NON-RESIDENT NO. OB22889 ADDRESS: INSURERISI AFFORDING COVERAGE NAIC # J56965-1.MMM-GAXWX-15-16 INSURER A: ACE American Insurance Company 22661 INSURED Martin Marietta Materials, Inc. Attm Todd Crump 2710 Wycliff Road P. 0. Box 30013 Raleigh, NC 27622 INSURER B : Indemnity Ins Co Of North America 43575 - INSURER C : N/A N/A INSURER D : Agri General Insurance Company 42757 INSURER E : INSURER F : /1CUTI11TIP`ATC d111aaDCO. ATI-on3R17m7-nR RFVI---glnN NI IMRFR- 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 LTR TYPE OF INSURANCE ADDL SUER - POLICY NUMBER POLICY EFF MM/DDlYYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY X HDOG27400425 09/30/2015 09/30/2016 EACH OCCURRENCE $ 3,000,000 CLAIMS -MADE FX] OCCUR DAMAGE TU-RENTED PREMISES Ea occurrence) $ 50,000 MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 6,000,000 PRODUCTS - COMP/OP AGG $ 6,000,000 X PRO ❑ LOC POLICY ElJECT OTHER. A AUTOMOBILE LIABILITY X ISAH08860701 09/30/2015 09/30/2016 COMBINED SINGLE LIMIT Ea accident) $ 3,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ $ ALL OWNED SCHEDULED AUTOS AUTOS X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident --- UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ XCESS LIAB CLAIMS -MADE IDED RETENTION $ $ B A D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A WLRC48592430 (ADS) WLRC48592429 CA ( ) TN WLRC48592417 ( ) 09/30/2015 09/30/2015 09/30/2015 09/30/2016 09/30/2016 09/30/2016 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 2,000,000 E.L. DISEASE - EA EMPLOYE $ 2,000,000 E.L. DISEASE -POLICY LIMIT 1 $ 2,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: 7377 Asphalt Supply Renewal. City of Fort Collins - Purchasing Division is included as additional insured (except workers' compensation) where required by written contract. A waiver of subrogation applies under Workers Compensation in favor of the certificate holder, if required by written contract with the named insured, subject to the terms and conditions of the policies. I- - !`A4If`GI I ATIn1U City of Fort Collins - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Purchasing Division THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Gerry Paul ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Nerissha Tucker U 19tftf-ZU14 AGUKU GUKt'UKA I IUN- An rlgnrs reserve0. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD