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HomeMy WebLinkAbout840824.tiff I I • 1 •1 �M¢ !;rpi le ' ` f Ii M" `'.IOi i%Ei r3 I lo. ri : BY 440 R f I :')'11' 1 4 1.5 rrff'RDIN• FRIZZELL & GRATRiX, INC . { - . -- 5353 W. Dartmouth, Suite 50C ( • !1. STANDARDINS. CO. (AETNA L.C.Gp) Denver, Colorado 80227 - Phone: (303) 969-6000 , 1I AETNA CASUALTY & SURETY . . _ i. DANIELS & ASSOC. et a.L i . j� Greeley Video, Inc. __ 3737 W. 10th Street Greeley, CO 80631 ' • i % F . t s 4 ave bee i .t i•c t r • ; r.r. .r'. i:; s .r . ::,a• .his tin ;h thi• • . "a'3 • = le•.. y; :' . $. a 'r afforc $ All states except A Texas #19GL191500CCS 1/1/84 x x x Texas — x 119GL196401CCS 1/1/84 x 500, 500, x x I 500, All states except A x Texas #19PJ010547CCS 1/1/84 •,,:: . x x Texas 500, u - #19AL577430CPS 1/1/84 All states including 15, 000, 15, 000, x Texas I . #19XS110967WCA_ --- -- -_-_1/1/84 A All states except -- - Calif. #19CY06410CPS 1/1/84 ':. : 5G0, 13 • Ca lit t9eiF9 846 i£�PA_.____i�l� I $100.ded.Comprehensive All states except A Auto Physical Texas 19PJ010547CCS 1/1/84 $250•ded.Coll.value to $20, • D4mage I Te� iip illiL /g444500.ded.Coll.value %;000. N I Per agreement with named insured. we dEs: r het .folio es oe c roe lei I e`o e H. expir mail __Q0 ci•iy• nr :tei urtri e to 'le hr loh nan impose n j o-t I'€at•cn. r lia! I ty of:r y ki id ,.won the • Notoer - ----1 it . Weld County Board of Commissioners I DA E ss=,Eo�_ January 1, 1983 915 10th Street / P.O. BOX 4592.4...„4:t_c_.; Greeley, CO 80631 7tti Attn: Mary Ann Fuerstein -M'-J _ William cratrix dio=u24 @MOtainBe!1 CERTIFICATE OF INSURAF ' ":E 7823 (7-82) THIS CERTIFICATE DOES NOT AMEND.EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW NAME.ADDRESS AND TEL NO OF AGENCY FRIZZELL & GRATRIX, INC. COMPANIES AFFORDING COVERAGES 5353 W. Darmouth Ave., Suite 500 CODenver, CO 80227 LETTERNY A STANDARD FIRE INS. CO. (AETNA L & C GP; COMPANY J LETTER AETNA CASUALTY & SURETY NAME AND ADDRESS OF INSURED DANIELS & ASSOC. ET AL COMPANY Greeley Video, Inc. LETTER 3737 W. 10th St. Greeley, CO 80631 COPALE MER"Y D COMPANY C LETTER - This IS to cerlit)/that policies of insurance listed below have been issued to the insured named above and are in force at this time.Notwithstanding any requirement,term or condition of any contract or other document with respect to which this certificate may he issued or may pertain,the insurance afforded by the policies described herein is subject to all the ter ms, exclusions and conditions of such policies. _ Limits of Liability in thousands (000) _ COMPANY TYPE OF INSURANCE POLICY NUMBER POLIC'r EACH LETTER EXPIRATION DATE OCCURRENCE AGGREGATE GENERAL LIABILITY • A ® BROAD FORM COMPREHENSIVE Gf NERAL LIABILITY 19GL 19500 CCS 1/1/84 BODILY INJURY $ S COMPREHENSIVE GENERAL LIABILITY ® PREMISES-OPERATIONS PROPERTY DAMAGE $ $ ® EXPLOSION AND COLLAPSE _HAZARD UNDERGROUND HAZARD ® PRODUCTS/COMPLETED BODILY INJURY AND OPERATIONS HAZARD M CONTRACTUAL INSURANCE* PROPERTY DAMAGE $ 500 $500 ® BROAD FORM COMBINED PROPERTY DAMAGE M INDEPENDENT CONTRACTORS - �r PERSONAL INJURY PERSONAL INJURY $500 ElcFIRE LEGAIXQ•EIX i3RB7CDf]SISEOX 50.000 LIMIT _ BODILY INJURY •aar• AUTOMOBILE LIABILITY (EACH PERSON) S O BODILY A g1.7t® COMPREHENSIVE FORM 1 9 PJ 010547 CCS 1/1/84 (EACH ACCIDENT) $ qS*t® OwNED PROPERTY DAMAGE S - ® HIRED BODILY INJURY AND $ 500 PROPERTY DAMAGE ® NON-OWNED COMBINED '+r EXCESS LIABILITY BODILY INJURY AND B ® UMBRELLA FORM 19 XS 110967 WCA 1/1/84 PROAGE 515,000 s15,000 COMBINED O OTHER THAN UMBRELLA FORM �& STATUTORY WORKER'S COMPENSATION A AND 19 CY 06410 CPS 1/1/84 EMPLOYER'S LIABILITY * r- - s S00 (EACH ACCIDENT) ARCHITECTS& ENGINEERS PROFESSIONAL LIABILITY OTHER - *Is Coverage provided for contractual liability assumed by Insured under the Contract or Contracts with Mountain Bell relating to the operations described(including indemnification provisions)?IX YES O NO DE SCRIPT ION OF OPERATIONS/LOCATIONS/VEHICLES Per license agreement ft o3:: weld County All Operations - All locations - All equipment & vehicles owned, leased or rented by named insured, in Colorado NOTICE OF CANCELLATION:Should any of the above described policies be cancelled before the expiration date ereof,the issuing company will mail at least (10)ten days advance written notice to the below named certificate holder. NAME AND ADDRESS OF CERTIFICATE HOLDER. Janua 1982 THE MOUNTAIN STATES TELEPHONE and TELEGRAPH COMPANY(MOUNTAIN BELL) DATE ISS D CONTRACT ADMIN. ATTN: CINDY MORGAN RM 1130-1 1005 17th ST. , DENVER, CO 80202 ALIT OR12E EPRESE NTATIVE WILLIAM GRATRIX The authority of the Agent to execute this certificate may be verified by calling the Insurance Company directly at 831-6730 Hello