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HomeMy WebLinkAbout498349 BANNER CONCRETE LLC - INSURANCE CERTIFICATE (5)BANNCON-01 JWITHERSPOON ACORO CERTIFICATE OF LIABILITY INSURANCE D 03 02/2018Y) `•--� 03/02/2018 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 WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on r4p848 is certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DUCER CONTACT pFS Insurance NA_ME_ Insurance Group Thompson Parkway Suite 200 A/C, N , Ext): (970) 635-9400 �n/c,No):(970) 635-9401nstown, CO 80534 �;"o"'_info@mypfsinsuralnce.com _ INSURED Banner Concrete, LLC 1313 Duff Dr #3 Fort Collins, CO 80524 INSURER F : Selective Insurance Company of America 139926 Pinnacol Assurance Co 141190 nn%IPQAr FC CFRTIFIRATF NI IMRFR• RFVIRIC)N 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_. INSRTYPE OF INSURANCE ADDLISUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS IN /DD/YYYY /DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000'000 -- DAMAGE TO RENTED EREMISE.$LEaoccurte— 500,000 $ CLAIMS -MADE X OCCUR X S2302963 03/01/2018 03/01/2019 MED EXP.SAny one person) _ PERSONAL & ADV INJURY $ 15,000 $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG 2,000,000 X POLICY JE� LOC Ih $ OTHER. A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ---- --- 1,000,000 $ — - -- - X ANY AUTO _ X S 2302963 03/01/2018 03/01/2019 _BODILY INJURY�PAuiersoq_ $ _BODILY INJURY_ Per accidents $ OWNED SCHEDULED AUTOS ONLY AUTOS PROPERTY DAMAGE Peraccident) _ $ ___._--__ _ HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ _ EXCESS LIAB �' CLAIMS -MADE, AGGREGATE $ DED RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE F- OFFICER/MEMBER EXCLUDED? j (Mandatory in NH) `-J N/A 146285 03/01/2018 03/01/2019 -� PER OTH- E.L. EACH ACCIDENT �- ---- E.L. DISEASE - EA E_M_PLOYEEi 1,000,000 $ $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT — 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) If required by written contract, the Certificate Holder is included as Additional Insured for ongoing operations under General Liability and Automobile Liability. City of Fort Collins Risk Management 215 North Mason Fort Collins, CO 80524 L;ANL; 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 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD