HomeMy WebLinkAbout20020846.tiff ACORD CERTIFICATE OF LIABILITY INSURANCko OP ID PS DATE(MM/DD/YY)
WEN-1 03/27/02
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Brown & Brown Inc - Longmont HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
825 Delaware, Suite P-102 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Longmont CO 80501
Phone: 303-776-3421 INSURERS AFFORDING COVERAGE
INSURED INSURER A MOUNTAIN STATES MUTUAL
INSURERD Pinnacol Assurance
Bowen Enterprises DBA -- - - -- -----
Centennial Backhoe INSURER C: _
P.O. Box 184 INSURER D.
Longmont CO 80501
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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY CPP006954901 01/09/02 11/01/02 FIRE DAMAGE(Any one fire) $ 100,000
CLAIMS MADE X OCCUR MED EXP(Any one person) ' $ 10,000
PERSONALS ADV INJURY $ 1,000,000
_ GENERAL AGGREGATE $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000
X I POLICY PRO- l ECT LOC - �-
AUTOMOBILE LIABILITY
SINGLE LIMIT $ 1 COMBINED
A X i ANY AUTO BAP0069550 01/09/02 11/01/02 000
(Ea accitle r000 r
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS ' (Per person)
HIRED AUTOS
BODILY INJURY $
NON-OWNED AUTOS i (Per accident)
--- - PROPERTY DAMAGE $-
li (Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO — _ -� ---
OTHER THAN EA ACC $ -
_--
AUTOONLY: AGG $
EXCESS LIABILITY .EACH OCCURRENCE $
OCCUR CLAIMS MADE AGGREGATE $
DEDUCTIBLE
RETENTION $ $
WORKERS COMPENSATION AND WC RSTA1 MI U TS- I°E
H-
TOY LI _ R
B EMPLOYERS'LIABILITY 1085770 04/01/02 04/01/03 EL.EACH ACCIDENT $ 100000
E.L.DISEASE-EA EMPLOYEE $ 100000
G_.uwe„oE-rUle_v LIMIT Is500000
OTHER
A Inland Marine CPP0069549 01/09/02 , 11/01/02 Owned Eq. $443,000
Rental Eq $ 50,000
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER N I ADDITIONAL INSURED;INSURER LETTER: CANCELLATION
WELDCOU SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL .S__DAYS WRITTEN
WELD COUNTY NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
DEPT. OF PUBLIC HEALTH & ENV.
1555 N. 17TH AVE. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
GREELEY CO 80631 REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Regina Casey
ACORD 25-S(7197)
f 2002-0846
CC7Lyj � 11i�N._ CJUA/Cj/6
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