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HomeMy WebLinkAbout105888 VALMONT INDUSTRIES - INSURANCE CERTIFICATE (4)A�o�D CERTIFICATE OF LIABILITY INSURANCE \TE(MM/DD/YYYY) 12,28/2D,6 E THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS 4PON THE CERTIFICATE"AOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE CO'r'ERAGE AFFORDED BY '.-HE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN T'.E ISSUING INSURERS). AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed..'.` SUBROGATION IS WAWED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on I:Ws certificate does not corer rights to the certificate holder in lieu of such endorsement(s). PRODUCER AOn Risk Services Central, Inc. Omaha NE Office CONTACT NAME: PHONE (402) 697-1400 FAX (402) 69'-1594 (AIC. No. Ext): AIC. No. 11213 Davenport Suite 201 E-MAIL ADDRESS: Omaha NE 68154 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: ACE American Insurance Company 22667 Valmont Industries, Inc. INSURER B: Continental Casualty Company 20443 Attn: Megan Wagner One Valmont Plaza INSURER C: Omaha NE 68154-5215 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570060695315 REVISION NUMBER: 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 PILL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD/YYYV MM/DD/YVYVl LIMITS A X COMMERCIAL GENERAL LIABILITY HDOG I EACH OCCURRENCE- $2 , 000, 000 CLAIMS -MADE OCCUR .General Liability �UAMA7 REN lei $1,000,000 P� REMISES Ea occurrence $10 , 000 L� MED E1tP (Any one person) PERSO.'- J�NJURY $1,000,000 t GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER. $4, 000, 000 POLICY FX JECT PRO ElLOC Lp;'r RODI ICTS - COMP/OP AGG $ 4 , 000 , 000 OTHER: A AUTOMOBILE LIABILITY ISAH08866454 01/01/2016 01/01/2017i COMBINED SINGLE LIMIT Ea accident $2, 000, 000 SIR applies per policy terns & condi ions BODILY INJURY ( Per person) ANY AUTO BODILY INJURY (Per accident) ALL OWNED SCHEDULED AUTOS AUTOS IHIRED AUTOS NON -OWNED PROPERTY DAMAGE Per accident AUTOS E B X UMBRELLA LAB X OCCUR L5094882742 01/01/2016 01/01/2017 EACHOCCURRENCE $25,000,000 EXCESS LIAR CLAIMS -MADE Umbrella AGGREGATE $25,000,000 DEC I X RETENTION $10, 000 A WORKERS COMPENSATION AND WLRC48597798 01/01/2016 01101120171X PER OTH- EMPLOYERS' LIABILITY YIN WC I STATUTE -R $1,000,000 ANY PROPRIETOR / PARTNER / EXECUTIVE N nl r a I E.L. EACH ACCIDENT I" CE14R=M, EP EXCU III" (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 A Archit&Enq Prof EONG24578215007 01/01/2016 01/01/20171Each Claim $5,000,000 A&EProfessional Liability !Aggregate $5,000,000 iRetertion $500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is requirfA Additional insured - The General Liability and Automobile Liability policies include a blanket automatic additional insured endorsement or policy terms that provide additional insured status to certificate holder - cluding the "products -completed operations" hazard where required by written contract. waiver of Subrogation - All politic;:: listed above include a blanket automatic waiver subrogation endorsement or policy terms that provide a waiver of subrogat,:on clly where required by written contract. Loss Payee - Automobile Liability policy includes a blanket loss payee endorsemel-it or policy terms tha* provide loss pa ee status to certificate holder where required by written contract. Coverage is primar;• and'non contributory. Umbrella po -icy follows form of underlying policies listed above. i CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCi ,!BED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE V'LL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins Financial Services; Purchasing Division AUTHORIZED REPRESENTATIVE 215 N. Mason street 2nd Floor PO BOX 580 Fort Collinsq CO 80522 USA /n m co rn 0 r- O Z tU f0 U w t G7 U ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 10576471 LOC #: A�ORL�� ADDITIONAL REMARKS SCHEDIIJLE Page _ of _ AGENCY Aon Risk Services Central, Inc. NAMED INSURED - Valmont Industries, :Cnc. POLICY NUMBER See Certificate Number: 570060695315 CARRIER See Certificate Number: 570060695315 NAIC CODE EFFECTIVE DATE ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,. FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Named Insured schedule AgSense, LLC Valmont Industries, Inc. v cascade Earth sciences, Ltd. George Industries, Inc. Valmont - southeastern Galvanizing, Inc. Valmont - Virginia Galvanizing, Inc. Valmont - Columbia Galvanizing, Inc. - Valmont - Birmingham Galvanizing, Inc. —41-t r i a 1, ral v— n i — rc A —rill ur,l rli— T— t r The ACORD name and logo are registered marks of ACORD