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475768 TRINITY STRUCTURAL COMPONENTS LLC - INSURANCE CERTIFICATE (5)
F3� TE (MM/DD/YYYY) A` O�RO® CERTIFICATE OF LIABILITY INSURANCE 7/2/2018 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: MHBT, a Marsh & McLennan Agency, LLC company PHONE - _ FAx 8144 Walnut Hill Lane, 16th Floor A/ No Ext 972 770-1600 A/C N : o 972 77 : 0-1699 I Dallas TX 75231 ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: ACE American Insurance Company 22667 INSURED TRINIINDI INSURER 8 : Trinity Structural Components, LLC P O Box 568887 INSURER C Dallas, TX 75356-8887 INSURERD: INSURER E : INSURER F : rf)VFRArF14 rFRTIFICATF NIIMRFR• 11Rr;nRA155 RFVISInN NIIMRFR- 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 SUBR POLICY NUMBER POLICY EFF MWDDNYYY POLICY EXP MM/DDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY HDOG7109733A 7/1/2018 7/1/2019 EACH OCCURRENCE $ 5,000.000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 50,000 X MED EXP (Any one person) $ 10,000 5,000,000 PERSONAL & ADV INJURY $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 7,000,000 PRODUCTS - COMP/OP AGG $ 7,000,000 X POLICY PRO LOC JECT � $ OTHER: A A AUTOMOBILE LIABILITY ISAH25159810 ISAH25159822 7/1/2018 7/1/2018 7/1/2019 7/1/2019 COMBINED SINGLE LIMIT Ea accident $ 5 000 000 BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Peraccident $ XXNON-OWNED HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N WLRC65225876 7/1/2018 7/1/2019 X STATUTE XI ER All States _ ANY PROPRIETOR/PARTNER/EXECU I VE OFFICER/MEMBER EXCLUDED? ❑N N/A E.L. EACH ACCIDENT $ 2,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ 2,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 2,000,000 -7 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder includes: City of Fort Collins, its officers, agents and employees The General Liability policy includes a blanket additional insured endorsement to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status. The Automobile Liability policy contains language that provides additional insured status to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status. CERTIFICATE HOLDER CANCELLATION City of Fort Collins Attn: Purchasing P O 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. AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD