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HomeMy WebLinkAboutVELMONT INDUSTRIES INC - INSURANCE CERTIFICATEA`ORL7 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/30/2016 I 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 Central, Inc. Omaha NE Office CONTACT NAME: NCC..NNo. Ezt); (402) 697-1400 FAX No.): (402) 697-1594 E-MAIL ADDRESS: 11213 Davenport Suite 201 Omaha NE 68154 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: ACE American Insurance Company 22667 Valmont Industries. Inc. INSURERB: Evanston Insurance Company 35378 Attn: Megan Wagner one Valmont Plaza INSURERC: The Continental Insurance Company 35289 INSURER D: Omaha NE 68154-5215 USA INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570065084355 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 INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MMIDD/YYVY POLICY EXP MMlDD/YYVV LIMITS A X COMMERCIAL GENERAL LIABILITY HDoG27861556 EACH OCCURRENCE $2 , 000, 000 CLAIMS -MADE � OCCUR General Liability AMA R N rence PREMISES Ea occur $1,000,000 MED EXP (Any one person) $10 , 000 PERSONAL &ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $4 , 000, 000 X POLICY � PRO ❑ LOC JECT PRODUCTS - COMP/OP AGO $4,000,000 OTHER: A AUTOMOBILE LIABILITY ISAH09053694 SIR applies per policy terns 01/01/2017 & conditions 01/01/2018 COMBINED SINGLE LIMIT Ea accident $2 , 000, 000 BODILY INJURY ( Per person) X ANY AUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HIRED AUTOS NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGE Per accident C X UMBRELLA LAB EXCESS LIAR P OCCUR CLAIMS -MADE 5094882742 umbrella 01/01/2017 01/01/2018 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 pRETENTION 410,000 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR / PARTNER / EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) It yes, describe under DESCRIPTION OF OPERATIONS below N I A wLRc49109313 WC 01/01/2017 01/01/2018 X PER OTH- STATUTE R E.L. EACH ACCIDENT $1,000,000 I . D!SEASE-EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 B Archit&Enq Prof MKLv7PL0002539 01/01/2017 03/01/2018 Each Claim $5,000,000 A&EProfessional Liability Aggregate $5,000,000 Retention $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Additional insured - The General Liability and Automobile Liability policies include a blanket automatic additional insured endorsement or policy terms that provide additional insured status to certificate holder including the "products -completed operations" hazard where required by written contract. waiver of Subrogation - All policies listed above include a blanket automatic waiver subrogation endorsement or policy terms that provide a waiver of subrogation only where required by written contract. Loss Payee - Automobile Liability policy includes a blanket loss payee endorsement or policy terms that provide loss payee status to certificate holder where required by written contract. Coverage is primary and non contributory. Umbrella policy follows form of underlying policies listed above. 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 Financial Services; Purchasing Division 215 N. Street 2nd Floor 580 Po Box 580 Fort Collinsq CO 80522 USA 6Go/e�e7d 7JG c m d a 0 2 0 Z d 16 w t W U ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 10576471 LOC #: A` C7�Ra►� ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Services Central, Inc. NAMED INSURED Valmont Industries, Inc. POLICY NUMBER See Certificate Number: 570065084355 CARRIER See Certificate Number: 570065084355 NAIC CODE EFFECTIVE DATE. 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liabilitv Insurance Named Insured Schedule Valmont Industries, Inc. AgSense, LLC George Industries, Inc. Valmont - southeastern Galvanizing, Inc. valmont - virginia Galvanizing, Inc. Valmont - Columbia Galvanizing, Inc. Valmont - Birmingham Galvanizing, Inc. Industrial Galvanizers America Holdings, Inc. industrial Galvanizers America, Inc. Matco Services, Inc. Pirod, Inc. (De) Valmont Coatings, Inc. (De) Valmont International Corp. valmont Newmark, Inc. valmont Northwest, Inc. Valmont Composite Structures, Inc. Valmont Service Centers, Inc. American Galvanizing Compnay, Inc. valley Exports, Inc. Cascade Earth Sciences Ltd. (umbrella Only) Pure Metals Galvanizing ULC (Umbrella Only) Lampadaires Feralux, Inc. (Umbrella only) Valmont West Coast Engineering Ltd. (umbrella only) valmont WC Engineering Group Ltd. (Umbrella Only) Valmont West Coast Engineering, Inc. ( umbrella Only) The ACORD name and logo are registered marks of ACORD