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Home My WebLink AboutPIERSON'S CONCRETE CONSTRUCTION CO - INSURANCE CERTIFICATE (7)P52(AX)2WK)2 ACORU° CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YIM 04/05/2018 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED, 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 1-303-534-4567 CONTACT NAME:_ _ _ PHONE FAX INA, Inc. - Colorado Division EaAAIL ADDRE denaccounttechseimacorp.car4 1705 17th Street INSURER(s) AFFORDING COVERAGE NAIC i suite 100 INSURERA:UNITED SPECIALTY INS CO (R-T Specialty) 12537 Denver, CO 80202 WSURED INSURERS: EMPLOYERS NUT CAS CO 21415 Pierson•s Concrete Construction Co. INSURER CPINNACOL ASSUR 41190 INSURER D: PO Box 271248 INSURER E : INSURERF: Fort Collins, CO 80527 COVERAGES CERTIFICATE NUMBER: 52534724 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 ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. — - -- _ --- POLIC WSR TYPE OF INSURANCE ADDL SUER POLICY NUYBER YYIDDY EFF POLICY TR M/� Y EXP LIMITS A X COMMERCIAL GENERAL LIABILITY ATHATL1871111 04/10/18 04/10/19 EACH OCCURRENCE S 1,000,000 CLAMAS-MADE ril OCCUR DAMAGE TO RCN PREMISES Ea 000u nc $ 50,000_ X MEDEXP(Any oneparaen) $ Excluded BI/PD Ded: $5,000 PERSONAL 4 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OPAGG $ 2.000,000 POLICY [�] JECT D LOC I $ OTHER: B AUTOMOBILE LIABILITY SX4544719 04/10/19 04/10/19 COMBINED SINGLE LIMIT(Ea accidont) $ 1,000,000 BODILY INJURY (Per Person) S ANY AUTO BODILY RUURY (Per sodden$ S OWNED SCHEDULED AUTOS ONLY AUTOS IZ = HIRED z NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTYDAMAGE Per acddeM $ $ A UMBRELLALIA0 X OCCUR BMS74539 04/10/18 04/10/19 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 Z EXCESS LUIB CLAIMS -MADE DED RETENTION $ C WORKERScoYPENSATNNA AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNERIEXECUTI— OFFICERIMEMBER EXCLUDED? IN I (Mandatory In NH) NIA 4055614 07/01/17 07/01/18 = STATUTE FOR E.L. EACH ACCIDENT_ S 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 N yes, desaibe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Sundulo, may be attached I more space Is requwd) City of Fort Collins: for Pierson?■ Concrete Summer BBQ 2017 City of Fort Collins is included as Additional Insured on the General Liability Policy if required by written contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions. I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ty of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 1190 AUTHORIZED REPRESENTATIVE /� Fort Collina I IISA , CO 80522 / /`v/,/% - / �'/� ® 1Vilb-L1170 AI:UKU (:UKYUKAI IUM. All ngnTs reserve0. S ACORD 25 (2016103) thcr5350 52534724 The ACORD name and logo are registered marks of ACORD