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HomeMy WebLinkAbout385548 AGGREGATE INDUSTRIES - INSURANCE CERTIFICATE-11 A%,. 0 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/2017 Y) 10/02/2017 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 Aon Risk Services Southwest, Inc. Houston TX office CONTACT NAME: PHONE (866) 283 7122 FAX (800) 363-0105 (A/C. No. Ext): (A/C. No.): E-MAIL ADDRESS: 5555 San Felipe suite 1500 Houston Tx 77056 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: ACE American Insurance Company 22667 AQQreQate Industries Management, Inc. 6211 Ann Arbor Road INSURER B: INSURER C: Dundee MI 48131 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570068795y49 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. Limits shown are as requested INSIR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM DD/YYYY MMlDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY HDOG 1 4 EACH OCCURRENCE $2 , 000 , 000 CLAIMS -MADE x OCCUR DAMAGE TO RENTED PREMISES Ea occurrence)$2 , 000 , 000 MED EXP (Any one person) $ 50 , 000 PERSONAL &ADV INJURY $2,000,000 GEN'LAGGREGATELIMITAPPLIESPER . GENERAL AGGREGATE $4,000,000 POLICY [ EX PRO ❑ LOC JECT PRODUCTS-COMPIOPAGG $4,000,000 OTHER. A AUTOMOBILE LIABILITY ISA-HO9064102 Auto (ADS) 10/01/2017 10/01/2018 COMBINED SINGLE LIMIT Ea accident $5 , 000 , 000 BODILY INJURY ( Per person) X ANYAUTO OWNED SCHEDULED BODILY INJURY (Per accident) AUTOS ONLY AUTOS HIREDAUTOS NON -OWNED ONLY AUTOS ONLY PROPERTYDAMAGE (Per accident UMBRELLA LAB EACH OCCURRENCE EXCESS LAB HOCCUR CLAIMS -MADE AGGREGATE DED I RETENTION A '0' WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A WLRC64620289 WC (AOS) SCFC64620277 wC (wI) 10/01/2017 10/01/2017 10/01/2018 10/01/2018 X I PER OTH- STATUTE iER E.L. EACH ACCIDENT $1 , 000 , 000 E.L. DISEASE -EA EMPLOYEE $1 , 000 , 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1 , 000 , 000 I F DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Insured is self -insured on physical damage for all owned, leased and rented autos. RE: All projects in and near the City of Fort Collins, CO. City of Fort Collins is included as Additional Insured as required by written contract, but limited to the operations of the Insured under said contract, per the applicable endorsement with respect to the General Liability and Automobile Liability policies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins AUTHORIZED REPRESENTATIVE Attn: Purchasing Department Po Box l l i Fort Collins ns Co 80522 USA ,%ra-rc`•/ G m rn c m 0 0 0 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000035837 LOC #: '4 ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Services Southwest, Inc. NAMED INSURED Aggregate Industries Management, Inc. POLICY NUMBER See Certificate Number: 570068795949 CARRIER See Certificate Number: 570068795949 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 Additional Named Insureds Aggregate Industries - Northeast Region, Inc. Tiger Minimix, Inc. Aggregate Industries - MWR, Inc. Kost, Inc. Super Concrete Corporation Bardon, Inc. D/B/A Aggregate Industries - Mar Aggregate Industries Land Company, Inc. Aggregate Industries - WCR, Inc. Aggregate Industries Management, Inc. Aggregate Industries - SwR, Inc. (D/B/A Frehner Construction Company) Meyer Material Company, LLC Lattimore Materials Corp. The ACORD name and logo are registered marks of ACORD