HomeMy WebLinkAbout120116 BESTWAY CONCRETE CO - INSURANCE CERTIFICATE (4)ACC>R" CERTIFICATE OF LIABILITY INSURANCE
2/DATE[M I DIYYYYI
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 endorsements .
PRODUCER
Commercial Risk Solutions
6600 E Hampden Ave Ste 200
Denver CO
CONTACT
NAME: Jessica Batten
vxoNE 303-996-7862 FAXAIC 303-757-7719
E-MAILcall.
. JBatten@crsdenver.com
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A:The Travelers Companies
INSURED BESTW-2
INSURERB:Pinnacol Assurance
41190
Bestway Concrete Company
Ed Foster
INSURER C
301 S. Centennial Dr.
INSURERD:
INSURER E
Milliken CO 80543
INSURER F:
rnVFRer.FS CFRTIFICATF NIIMRFR• 1801523711 RFVIQlnfd 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
INSD
WVD
POLICY NUMBER
POLICY EFF
MIWDD/YYYY
POLICY EXP
MMIDD/YYYYI
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE ❑X OCCUR
Y-630-5F600378
3/1/2016
3/1/2017
EACH OCCURRENCE
$1,000,000
DAMAGE TO RENTED
PREMISES Ea occurrence
$100,000
MED EXP (Any one person)
$5,000
PERSONAL B ADV I NJURY
$1,000,000
GEN'L AGGREGATE LI MIT APPLIES PER:
PRO -
X POLICY JECT PRO ❑ LOC
OTHER:
GENERAL AGGREGATE
$2,000,000
PRODUCTS - COMP/OP AGG
$2,000,000
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
AUTOS JED AUTOESULEDBODILY
HIRED AUTOS x NON -OWNED
AUTOS
Y-810-5F600378
3/1/2016
3/1/2017
COMBSINGLE LIMIT
INED
$1,000,000
BODILY INJURY (Per person)
$
Ix
INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
A
X
I UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
YSM-CUP-5F600378
3/1/2016
3/1/2017
EACH OCCURRENCE
$2,000,000
AGGREGATE
$2,000,000
DED X I RETENTION$ 10,000
$
B
WORKERS COMPENSATION
AND EMPLOYERIPLIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE F-Y]
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) - _
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
4026925
3/1/2016
3/1/2017
PER OTH-
X I STATUTE ER
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE - EA EMPLOYEE
$500,000
EL DISEASE -POLICY LIMIT
1 $500,000
A
Leased/Rented Equipment
6603E976090
3/1/2016
3/1/2017
Limit 250,000
Deductible 5,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more apace Is required)
All policy terms, conditions and exclusions apply.
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.
REPRESENTATIVE
@ 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD