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Home My WebLink About498349 BANNER CONCRETE - INSURANCE CERTIFICATE (3)BANNCON-01 NROYBAL CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 3/3/2016 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 PFS Insurance Group 4848 Thompson Parkway Suite 200 Johnstown, CO 80534 CONTACT NAME: PHONE FAX A/C No Ext : (970) 635-9400 A/c No): (970) 635-9401 A-MADDRESS: � YPfsinsurance.com EIL info@mypfsinsurance.com INSURER(S) AFFORDING COVERAGE NAIC q INSURER A: Liberty Mutual Group 41785 INSURED INSURER B:Pmnacol Assurance CO 41190 Banner Concrete, LLC Linda Vogel 716 Peterson Street INSURERC: INSURER D INSURER E : Fort Collins, CO 80524 INSURER F : UUVt:HA0E5 CERTIFICATE NUMBER: RFVlclnu MI 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 INSD WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICYEXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FXI OCCUR BKS55371437 03/01/2016 03/01/2017 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 300,000 MED EXP (Any one person) $ 15,000 PERSONAL B ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO- JECT ❑ LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 Is OTHER: A AUTOMOBILE LIABILITY ANY AUTO BAS55065194 - 02/22/2016 02/22/2017 COMBINED SINGLE LIMIT Ea accident)$ 1,000,000 X BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIREDAUTOS NON -OWNED AUTOS PROPERTYDAMAGE Per accident $ $ UMBRELLA LJAS OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I I RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICERIMEMBER EXCLUDED? � N / A 146285 03/01/2016 03/01/2017 PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - FA EMPLOYEE $ 1,000,000 (Mandatory In NH) If es, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, AddlUonal Remarks Schedule, maybe attached U more space is required) If required by written contract or written agreement, the certificate holder is Included as additional Insured for ongoing operations under general liability and automobile liability. City of Fort Collins Risk Management 216 N. Mason Fort Collins, CO 80524 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 U 1983-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD