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Home My WebLink About20020267.tiff CERTIFICATE OF INSURANCE ISSUE DATE (MM/DD/YY) : 01/16/2002 COW AGENT SA042998 ITHISCERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, RUSSELL K. JORGENSEN EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO BOX 300512 - t-.a? a'° /1 n: 31 GLENWOOD UT 84130-6n4.2 COMPANIES AFFORDING COVERAGE COMPANY NATIONAL FARMERS UNION PROPERTY AND CASUALTY COMPANY INSURED CO-8080918 j-i I .__'A) NUNN TELEPHONE COMPANY COMPANY NATIONAL FARMERS UNION STANDARD INSURANCE COMPANY I B P.O. BOX 148 NUNN CO 80648-0148 COMPANY C THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO. TYPE OP INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY LIMITS CO DATE EFFEC DATE (MM/DD/YY) B GENERAL LIABILITY 2RU0162894 01/01/2002 01/01/2003 GENERAL AGGREGATE $ X-COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG $ 2,000,000 -- ❑CLAIMS MADE ❑X OCCURRENCE PERSONAL 6 ADV INJURY $ INCLUDED X CONTRACTOR'S PROTECTIVE EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire) $ 70,000 MED EXP (Any one person) $ 5,000 B AUTOMOBILE LIABILITY 2RU0162894 01/01/2002 01/01/2003 COMBINED SINGLE LIMIT $ 1,000,000 X-ANY AUTO BODILY INJURY (per person) $ ALL OWNED AUTOS BODILY INJURY (per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS • NON-OWNED AUTOS GARAGE LIABILITY AUTO ONLY - EACH ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: $ - EACH ACCIDENT $ AGGREGATE $ B EXCESS LIABILITY 2030258132 01/01/2002 01/01/2003 EACH OCCURRENCE $ 2,000,000 ---I UMBRELLA FORM AGGREGATE $ 2,000,000 OTHER THAN UMBRELLA FORM $ WORKERS' COMPENSATION AND I STATUTORY LIMITS EMPLOYERS' LIABILITY EACH ACCIDENT $ 0 THE PROPRIETOR/ INCL. DISEASE - POLICY LIMIT $ 0 PARTNERS/EXECUTIVE - OFFICERS ARE: EXCL. DISEASE - EACH EMPLOYEE $ 0 OTHER B REAL AND PERSONAL PROPERTY 2RU0162874 01/01/2002 01/01/2003 ALL OTHER PERIL $ 1,202,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS: I CERTIFICATE HOLDER CANCELLATION: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE BOARD OF COUNTY COMMISSIONERS EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 COUNTY OF WELD DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON 915 TENTH ST THE COMPANY,ITS AGENTS OR REPRESENTATIVES. GREELEY CO 80631 �//� / [�/] �1'I .0,,,, ,t agenda.- / AUTHORIZED REPRESENTATIVE /JOIZIt ,,, 4 Jll�lQ - Si) - dOdcR / 2002-0267 NATIONAL FARMERS UNION 11900 East Cornell Avenue - STANDARD INSURANCE COMPANY Aurora, Colorado 80014-3194 (303) 337-5500 Rural Utilities Insurance Plan - Declarations Customer # Policy # Policy Period FROM: 01/01/2002 TO: 01/01/2003 PREMIUM: $ 3,512 CO-8080918 2RU0162874 12:01 AM Standard Time at the address shown below. PA: 52 Named Insured and Address: AGENT: SA042998 RUSSELL K. JORGENSEN PO BOX 300512 NUNN TELEPHONE COMPANY GLENWOOD UT 84730-0512 P.O. BOX 148 (435) 896-6600 NUNN, CO 80648-0148 INSURANCE APPLIES ONLY TO THOSE COVERAGES FOR WHICH A LIMIT OF LIABILITY IS SHOWN AND THIS COMPANY SHALL NOT BE LIABLE FOR MORE THAN THE LIMIT OF LIABILITY SPECIFIED FOR EACH COVERAGE. PROPERTY AND RELATED COVERAGES LIMIT OF LIABILITY --- PROPERTY DEDUCTIBLES --- Real and Personal Property $ 1,202,000 $ 1,000 Deductible Per Occurrence Automatic Increase in Insurance 3.0 Percent Personal Property of Others $ 50,000 VALUE PROTECTION GROUP $ 250,000 AGGREGATE LIMIT APPLIES TO ALL OF FOLLOWING: Loss of Use $ Newly Acquired Property $ Accounts Receivable $ Property Off Premises $ Valuable Papers & Records.. $ Electronic Data Processing S IF AN AMOUNT IS SHOWN AFTER A SPECIFIC COVERAGE, THAT AMOUNT WILL BE IN ADDITION TO THE VALUE PROTECTION GROUP AGGREGATE AMOUNT FOR THAT SPECIFIC COVERAGE. LIABILITY AND RELATED COVERAGES LIMIT OF LIABILITY Bodily Injury, Property Damage, Personal Injury, and Advertising Injury $ 1,000,000 Per Occurrence Products-Completed Operations Hazard S 2,000,000 Aggregate Limit Premises Medical Coverage $ 5,000 Each Person/525,000 Each Occurrence Fire Legal Liability - Real Property S 50,000 Each Occurrence Telephone Directory Liability $ 1,000,000 Aggregate Limit Broadcasters Liability $ 1,000,000 Aggregate Limit AUTO COVERAGES I. Auto Liability LIMIT OF LIABILITY Bodily Injury and Property Damage $ 1,000,000 Each Occurrence Uninsured/Underinsured Motorist $ 1,000,000 Each Occurrence Auto Medical Payments $ 2,000 Each Occurrence II. Auto Physical Damage Comprehensive Actual cash value less $250 Deductible Collision Actual cash value Less $500 Deductible CRIME COVERAGES S 40,000 Limit of liability per occurrence applies to the combined crime coverages below: Employee Dishonesty CRIME DEDUCTIBLES Forgery or Alteration $500 Deductible per Occurrence Theft, Disappearance, & Destruction Robbery and Safe Burglary POLICY FORMS/ENDORSEMENTS ATTACHED AT INCEPTION: RP-101(5/88), RP-116(5/88), RP-120(8/93), RP-207(10/96), RP-193(6/01), RP-208(4/99), RP-102(8/93), RP-103(1/92), RP-104(5/88), RP-154(5/88), RP-121(4/95), RP-112(5/88), CA2203(10/99), CA2150(9/01), RP-134(9/00), SPEC END-1 TO SPEC END-2. AUTHORIZED SIGNATURE DATE FORM RP-100(5/88) Hello