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HomeMy WebLinkAbout497786 MARTIN MARIETTA MATERIALS - INSURANCE CERTIFICATE (24)DATE /YYYY) CERTIFICATE OF LIABILITY INSURANCE F09/29/201712017 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 this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Marsh USA Inc. NAME: _ _ 100 North Tryon Street, Suite 3600 PHONE IFAX (AIC, No): Charlotte, NC 28202 EMAIL Attn: CA NON-RESIDENT N0.OB22889 ADDRESS: - — - --- --- - INSURER S AFFORDING COVERAGE _ NAIC # J56965-1.MMM-GAWX-17-18 INSURER A: ACE American Insurance Company 22667 INSURED INSURER B : Indemnily Ins Co Of North America 43575 Martin Marietta Materials, Inc. Attn: Todd Crump INSURER c : ACE Property And Casualty Ins Co 20699 2710 Wycliff Road PO Box 30013 INSURER D Raleigh, NC 27622 INSURER E : COVERAGES CERTIFICATE NUMBER: ATL-004700079-02 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 INSD wyn SUER POLICY NUMBER MM/DDIYYYY(MOM DD YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY HDOG27871525 09/30/2017 09/30/2018 EACH OCCURRENCE $ 3,000,000 CLAIMS -MADE � OCCUR DAMAGE RENTED PREMISES Ea occurrence $ 50 000 MED EXP (Any one person) $ _ PERSONAL & ADV INJURY $ 3,000,006 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 6,000,000 X POLICY 1:1 PRO JECT ❑ LOC PRODUCTS - COMP/OP AGG $ 6,000,000 $ OTHER: I A AUTOMOBILE LIABILITY ISAH09063717 09/30/2017 09/30/2018 COMBINED SINGLE LIMIT Ea accident $ 5,000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ _ X UMBRELLA LIAR X OCCUR G28167581002 09/30/2017 09/30/2018 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 EXCESS LIAB CLAIMS -MADE DIED I I RETENTION $ $ B A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBEREXCLUDED? N (Mandatory in NH) N/A WLRC64619457 (ADS) WLRC64619792 (CA) 79KMTr 09130/2017 09/30/2018 0913012018 X IPER I I OTH- STATUTE ER E.L. EACH ACCIDENT $ 2,000,000 E L DISEASE - EA EMPLOYEE $ 2,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: 2017 City of Fort Collins Overlay Project - 1633272577 City of Fort Collins is/are additional insured under General Liability and Automobile Liability as their interest may appear, if required by written contract with the named insured, subject to the terms and conditions of the policies, A waiver of subrogation applies under General Liability, Automobile Liability, Workers Compensation, and Umbrella Liability in favor of the certificate holder, if required by written contract with the named insured, subject to the terms and conditions of the policies General liability and auto liability insurance apply on a primary and non-contributory basis, if required by written contract, and subject to policy terms and conditions. lha:illIl2Lh-\I;0:Lei MDIaa City of Fort Collins Purchasing Div. 215 N. Mason St. 2nd Floor 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 of Marsh USA Inc. Annette Stefani ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD