HomeMy WebLinkAbout20021298.tiff Client# : 12186 IDESE
ACDRDTM CERTIFICATE OF LIABILITY INSURANCE 05/02/02
PdODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Ins . Inc . ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P . O- Box 578 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
4687 W. 18th Street
Greeley, CO 80632 • • INSURERS AFFORDING COVERAGE
INSURED INSURER A: The Hartford Insurance
Ideal Services Corp.
INSURER B: Pinnacol Assurance
P. O. Box 328
INSURER C:
Greeley, CO 80632
INSURER D: - -- -
I 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 CLAIMS.
INSR ---- - ---- T -- __- --- - POLICY EFFECTIVE POLICY EXPIRATION-�--- - - _- ---
LTR TYPE OF INSURANCE i POLICY NUMBER DATE(MWDDNY) DATF(MWDDNYI LIMITS
A GENERAL LIABILITY 34UUNFY6547 05/01/0Z- 05/01/03 EACH OCCURRENCE I$1 , 000, 000
X COMMERCIAL -
A. ' FIRE DAMAGE(Any one lire) 18300/ 000
CLAIMS ERXLI
MADE OCCUR MED EXP(Any one person) !.-P.,.-0 0 0
'., PERSONAL AADV INJURY 81, 000, 000
i GENERAL AGGREGATE $2 , 000L000
IGENt AGGREGATE LIMIT APPLIES PER: I PRODUCTS COMP/OPAGG $2 , 000, 000
POLICY I 7ECT HOC
- �- -- � --
A AUTOMOBILE LIABILITY 34UENFY6915 05/01/02 05/01/03 COMBINED SINGLE LIMIT
X ANY AUTO i(Ea accident) .$1, 000, 000
ALL OWNED AUTOS I, BODILY INJURY
(Per person) $
SCHEDULED AUTOS
!
' HIRED AUTOS '.
I BODILY INJURY $
NON-OWNED AUTOS (per accident)
- _ -_ PROPERTY DAMAGE $
I(Per accident)
I
GARAGE LABILITY 'AUTOONLY-EA ACCIDENT $
I ANY AUTO EA ACC $
OTHER THAN
AUTO ONLY: AGG $
A EXCESS LIABILITY 34XHUFY6334 05/01/02 05/01/03 EACH OCCURRENCE ,!3000, 000
OCCUR CLAIMS MADE I AGGREGATE f$3,000, 000
i
DEDUCTIBLE $
RETENTION $ I I$
B WORKERS COMPENSA HON AND 14029471 05/01/02 05/01/03 TORY LM fS �'IOER .
EMPLOYERS'LIABILITY EL.EACH ACCIDENT '$1, 000 , 000
E.L.DISEASE-EA EMPLOYEE $1, 000 , 000
11 E.L.DISEASE-POLICY LIMIT $1, 000 , 000
,I OTHER !I
I
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION
SHOULD ANYOFTH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
Weld County Health 8t Planning DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL-__-DAYS WRITTEN
Attn: Marsha Walters NOTICE TOTHE CERTIFICATE HOLDER NAMED TOTHE LEFT,BUT FAILURE TO DOSOSHALL
1555 North 17th Avenue IM POSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
Greeley, CO 80631 REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD25-S(7/97)1 of 2 #S215154/M214963 MMP 3
L 2002-1298
enxit. (2j.ei 05/2o/2coa-
Hello