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Home My WebLink About20100244.tiff ,--, ACORD. CERTIFICATE OF LIABILITY INSURANCE DATEIMMIDD/YYY L/ 11/18/2009 PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION MARSH USA INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE • TWO LOGAN SQUARE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR PHILADELPHIA, PA 19103-2797 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Attn: ComcasLCerts@marsh.com Fax:212-948-0360 05194-ALL-GAM-09-10COMC DENVE CO INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:ACE American Insurance Company 22667 COMCAST OF CALIFORNIA/COLORADO/TEXAS/ _.._. WASHINGTON, INC. INSURER B'ACE Property And Casualty Ins Co 20699 P. O. BOX 5630 DENVER, CO 80217-5630 INSURER clndemnity Ins Co Of North America ;43575 .:. INSURER D- . INSURER E 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 CI AIMS. INBrZADD'); TYPE OF INSURANCE POLICY NUMBER POLICY ErrEcnvE PDucY EXPIRATION LIMITS 'LTRI INSRD DATE MMmD ( IYYYY) DATE(MM/DNYYYYI ',, .GENERAL LIABILITY EACH OCCURRENCE ,$ 4,900,01 DAMAGE TO RENTED A ' IX COMMERCIAL GENERAL LIABILITY IXSL G24936855 12/01/2009 12/01/2010 PREMISESIEa occurrence) :$ 4,900,01 CLAIMS MADE I�X OCCUR • MED ExP(Any one person) $ 10,01 PERSONAL&ADV INJURY $ 4,900,01 X .$100,000 SIR ; I'GENERAL AGGREGATE $ 26 000,01 GENERAL AGGREGATE LIMIT APPLIES PER • • PRODUCTS-COMP/OP AGG$ 6,0000 PRO- X 1 POLICY JECT I LOC - AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT $ 5,000,01 A X ANY AUTO ISA H08581447(AOS) 12/01/2009 12/01/2010 (Ea accident) ALL OWNED AUTOS "I BODILY INJURY $ SCHEDULED AUTOS IPer Censer-II I I HIRED AUTOS la , BODILY INJURY $ - I ; NON-OWNED AUTOS (Per accident) f-I PROPERTY DAMAGE I I IPerawiaent) IS I GARAGE LIABILITY AUTO ONLY-EA ACCIDENT($ -I ANY AUTO I OTHER THAN EA _ii AUTO ONLY. AGG I EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE — $ 5,000,01 B X I OCCUR CLAIMS MADE I XOO G24874266 12/01/2009 12/01/2010 AGGREGATE ..$ 5,000,01 I _- DEDUCTIBLE __-._ - -$.. RETENTION S __ R G WORKERS COMPENSATION AND WLR C4 5707064(AOS) 12/01/2009 12/01/2010 X I INC STATU- oTN- A EMPLOYERS'LIABILITY WLR C45707040 (CA) 12/01/2009 12/01/2010 - ITORY LIMITS. ER ANY PROPRIETOR/PARTNER/EXECUrIVE YIN E L.EACH ACCIDENT $ 2,080,0( A OFFICER/MEMBER Excu)DeO, WLR C45707052(MN) 12/01/2009 12/01/2010 A N SCF C45707076(WI) 12/01/2009 12/01/2010 E_L-DISEASE-EA EMPLOYEE$ 2,000,0( • (Mandatory SPECIALin NH)IT yes,describe under EL.DISEASE-POLICY LIMIT $ 2,000,0( PROVISIONS below OTHER , A EXCESS AUTO LIABILITY IXSA H08583365 12/01/2009 12/01/2010 LIMIT $5,000,0C DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS I CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED AS RESPECTS THE GENERAL LIABILITY POLICY WHERE REQUIRED BY WRITTEN I CONTRACT WITH THE NAMED INSURED. $100,000 PER OCCURRENCE SELF INSURED RETENTION APPLIES ONLY TO THE ABOVE GENERAL LIABILITY POLICY. ► .1t H CERTIFICATE HOLDER CLE-002138393-13 CANCELLATION !I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE COUNTY OF WELD EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ! ATTN: COUNTY ATTORNEY 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. WELD COUNTY CLERK&RECORDER 915 10TH STREET BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND A GREELEY,CO 80632 UPON THE INSURER, ITS A^^ AGENTS OR REPRESENTATIVES. A f soRsh DRE REPRESENT/LIME ,ifrna-i /'a IQ.W µ, �- O ( 9 27 7'I '71C- Mary Redaezewski i 4 1 . // _J.Y//' ( /' .a /L- ) ACORD 25(2009/01) (-j7/`) �i /l ©1998-2009 ACORD CORPOF 2010-0244 / / V The ACORD name and logo are registered marks of ACORD IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. A statement 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 This Certificate of Insurance 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. O Acord 25(2009/01) Hello