HomeMy WebLinkAboutCOLOSCAPES CONCRETE INC - INSURANCE CERTIFICATE 2023-2024 (2)A`�R�� CERTIFICATE OF LIABILITY INSURANCE �s�i�� oz3 �
THIS CERTIFICATE IS ISSUED AS A MAT7ER OF IN�ORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HQLUER. THIS
CERTIFICATE DOES NdT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICI�S
BELOW. THIS CERTIFiCATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING iNSURER(5j, A�ITHORIZED
REPRESEN7A71VE OR PRODUCER, AND THE CERTIFICATE HOLUER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSUREp, the policy{iesj must 6e endorsed. If SUBROGATION IS WAIVED, sub}ect to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate ctqas not confer rights to the
certificate holder in lieu of such endorsertsent(s}.
PRODl1C6R NAME: Kylle Carey, CISR� CIC
Flood and Peterson �CNNo E�: (970}266-7198 /{�C NO: �97n�S06-68�5
e.0. Box 578 Qo�Ess: KCarey@floodpeterson.com
Greeley CO 80632 ips
INSURED
INS
Coloscapes Concrete, Inc. iNs
3553 Clydesdale, 5uite 110 ips
lN3
Loveland CO 80538 iNs
COVERAGES CERTIFICATE NUMBER:GL,CAu,xs,wC,
REVI510N NUlNBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURAMC@ LISTEq 8�l.OW HAVE BEEN ISSUED TO 7HE INSURED NAMEd ABOVE FOR THE POIiCY PERIO�
INDICATED. NQTWITH$TANDING ANY R�QVIREMENT, TERM OR CONDITION OF pNY CONTRACi OR OTHER DOCUMEN� WITH RESPECT TO WHICH THIS
CERTIFIGATE MAY B� ISSUE� OR MAY PERTAIN, THE INSURANCE AFFOR�ED 8Y THE POLICIES DESCRIBED HEREIN �S SUBJECT TO ALL THE TERMS,
EXCLUSIQNS AND CONp1710NS OF SUCH POLICIES. LIM�TS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS_
lNSR 7ypE OF INSURANCE U POLICY EFF POLICY E%P LIMITS
LTR POLICY NIIMBER MMlDOIYYYY MMlD�/VYYY
X COMMERCIA4 GENERAL 1IA61417Y EACH OCCURRENCE S 1, 000, 000
A CLAIMS�MAUE � OCCUR PREMlSE5 Ea occurtente S 500, 000
ZAGL89257901 6/1/2023 6/1/2024 MED EXP {Any One per30n) S 10, 000
PERSONAL & AOV INJURY S 1, OOD, 000
GEN'LAGGREGATE LIMIT APPLIES PER GENERALAGGREGATE S 2� OOO � OOO
POLIGY � �Ea � LOC PRODl1CT5-COMPfOPAGG S 2,004,000
07HER 5
AUTOMOBILE LIABILITY MBIiJE� IN LE LIMlT S 1, 000, 000
Ea acatlenl
A x ANYAUTO 6ODILYINJURY(Perpe75onJ S
ALLOY4NE0 SCHEi1ULE0 yp�pTgp44101 6/1/2023 6!1l�C��9 BODILY INJURY (Peractldentf S
AUTOS AU70S
X HIRE�AUTOS X NON-OWNE� PROPERTY�AMpGE g
AUTOS Per acutlent
unms�ree mo�onsi comdneA s�ngie S 1, 000 , 000
X UMBRELLALIAB X p�CUR EACH OCCURqENCE 5 5 OD0,000
B EXCESSLIAB CLAiMS•MADE AGGREGATE 5 5,UOO,aao
OED RETENTIOI� 5 CUP-5H163513-23-NF 3/1/2023 6/1/2029 5
WORKERS COMPENSATIDN
x PER q7H-
AN� EMP�OYERS' LIABILI7Y Y � M TATUTE ER
ANY AROPRIETORlpARTNERIEXECU7NE E.L EACH ACCIUEMT S 1� UOO � OOO
p+ Manda oM�n NN �xCWdEd� � N!A ��19999801 6/1/2023 6/1/2029
( ry� 1 E, L DISEASE - EA EMPLOYEE 5 1, 000 , 000
If yes. Aesaibe untler
�ESCRIPTION OF OPERATIONS De�aw E,L DISEASE - POLICY LIMIT 5 1 000 000
C Pollution/Pro£. Liabi2iCy PEC2000383 3/1/2023 6/1/2024 52.0OO.OUOf52.000.00U
D Leased/Rented EQuipm@nt THA95005a4 6/1/2a23 6/1/2o2a 5]66.00Ol�mR+St.0000e0ud�de
DESCRIPTION OF OPERAnONS! LOGA7IONS! VEHIGLES �AGORD t01, Add�tionsl qemarks ScTrtlul�, may Ee attachad �f mon spae� is �aquiredj
Ly�:�Il�[9_tii�.C�]�l�l�:�
City of Fort Collins
281 N College
Fort Collins, CO 80524
ACORD 25 (2014101j
INS025 �2oiaoi�
;f7_V [�i���_tlC�]:I
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLEU BEFORE
THE EXPIRAT{ON DATE THEREOF, NOTIGE WILL BE DELIVERED IM
ACCORDANCE WITH THE POLICY PROVISIONS.
AU7NORIZED REPRESENTATVE
K Carey, CISR, :`1"�''�: �"�
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