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Home My WebLink AboutPeterson Contractors-3/15/2010 (2)ACCORD CERTIFICATE OF LIABILITY INSURANCE ker.'. DATE(MM/DD/YYYY) 03/05/2010 PRODUCER LSB Financial 219 Main Street Cedar Falls, IA 50613 Ph: 319-268-4242 Fax: 319-268-4211 THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Peterson Contractors, Inc. Reinbeck Motors, Inc. PO Box A 104 Blackhawk Street Reinbeck, IA 50669 INSURER A: The Travelers Indemnity Company 25658 INSURER B: Travelers Property Casualty Company 25674 INSURER c: The Travelers Indemnity Company of CT 25682 INSURER D: The Travelers Indemnity Company 25658 INSURER E: $ 1,000,000 COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRADD'L LTR INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DDNY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY VTNCO7880B883PHX09 07/01/2009 07/01/2010 EACH OCCURRENCE $ 1,000,000 X DAMAGE (Ea RENTED 300,000$ 300,000 CLAIMS MADE X OCCUR MED EXP (Any one person) $ 10,000 X Blanket Contractual PERSONAL &ADV INJURY $ 1,000,000 X XCU Coverage Included GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY n JECTT n LOC PRODUCTS - COMP/OP AGG $ 2,000,000 —7 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS VTJCAP3510A26ATILO9 07/01/2009 07/01/2010 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE UABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ A EXCESS/UMBRELLAUABIUTY I OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ 10,000 VTSMKCUP3510A271INDO9 07/01/2009 07/01/2010 EACH OCCURRENCE $ 1,000,000 " AGGREGATE $ 1,000,000 $ $ X $ C WORKERS COMPENSATION AND EMPLOYERS' UABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below VTC2EU 89123885509 07/01/2009 07/01/2010 X OR STLIMITATU-S ER °TH- RY E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 D OTHER Cargo Rent / Lease Equipment QT660140D7836T1A09 07/01/2009 07/01/2010 $ 800,000 $ 750,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROV SIONS FOR THE PROJECT DESCRIBED AS FY 2010 SALVAGED ASPHALT CRUSHING CONTRACT ID # 785, THE CITY OF WATERLOO IOWA IS NAMED AS AN ADDITIONAL INSURED PER WRITTEN CONTRACT REQUIREMENTS. PCI # J3059 CERTIFICATE HOLDER CANCELLATION CITY OF WATERLOO DEPARTMENT OF ENGINEERING 715 MULBERY STREET WATERLOO, IA 50703 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR UABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001/08) ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statment on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08)