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Home My WebLink AboutANDALE READY MIX CENTRAL INC / ANDALE CONSTRUCTION - INSURANCE CERTIFICATEAc"Rb- CERTIFICATE OF LIABILITY INSURANCE 10/1/2018 DATE(MM/DD/YYYY) 1 9/22/2017 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 Lockton Companies 444 W. 47th Street, Suite 900 Kansas City MO 64112-1906 (816) 960-9000 CONT NAMEA T NE AX AMA No,Ext : A/C, No ADDRESS: INSURER AFFORDING COVERAGE NAIC # INSURER A : Zurich American Insurance Company 16535 INSURED ANDALE READY MIX CENTRAL, INC. INSURER B : Rockhill Insurance Company 28053 1360446 ANDALE CONSTRUCTION, INC. 3170 N. OHIO INSURER C: Zurich North America WICHITA KS 67219 INSURER D : INSURER E : INSURER F : C0VFRAr,FC * CFRTIFICATF NHMRFR- 14721 1 10 REVISION NUMBER: XXXXXXX 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 ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS C X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR Y N GLOO183143-01 10/1/2017 10/1/2018 EACH OCCURRENCE 1,000000 DAMAGES ( RENTED PREMISES Ea occurrence 100,000 MED EXP An one person)5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY7 jECT X� LOC PRODUCTS -COMP/OPAGG $ 210001000 $ OTHER C AUTOMOBILE LIABILITY Y N BAP0183144-01 10/1/2017 10/1/2018 (COaBINEDtSINGLE LIMIT $ I ,OOO OOO BODILY INJURY (Per person) $ XXXXXXX X ANY AUTO OWNE ONLY SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident $ XXXXXXX PROPERTY DAMAGE Per accident $ XXXXXXX HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY $XXXXXXx 13 X UMBRELLA LIAB X OCCUR N N FF01881901 10/1/2017 10/1/2018 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 51000,000 EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $XXXXXXX C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? IMandatory in NH) N / A N WC0183142-01 10/1/2017 10/I/2018 PER OTH- X I STATUTE ER E.L. EACH ACCIDENT $ I M0 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 A INSTALLATION FLOATER N N CPP 0140456-03 10/1/2017 10/1/2018 LIMIT: $250,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER IS ADDITIONAL INSURED ON GENERAL LIABILITY AND AUTO LIABILITY COVERAGE, IF REQUIRED BY WRITTEN CONTRACT AND SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY. THE INSURANCE EVIDENCED BY THIS CERTIFICATE WILL NOT BE CANCELLED OR MATERIALLY ALTERED, EXCEPT AFTER TEN (10) DAYS WRITTEN NOTICE HAS BEEN RECEIVED BY THE CITY OF FORT COLLINS. 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. 14721110 AUTHORIZED REPRESENTATIVE CITY OF FORT COLLINS PURCHASING DEPARTMENT PO BOX 580 FORT COLLINS CO 80522� Ar,rwn 94 v2nia/nst 0)1 8-2015 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD