HomeMy WebLinkAbout20030400 ISSUE DATE (MM/DD/YYI : 01/30/2003
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*VOW" CERTIFICATE OF INSURANCE
AGENT SA042998 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO
RIGHT UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND
RUSSELL K. JORGENSEN OR ALTER THE COVERAGE AFFORDED BY THE POLICY BELOW.
PO BOX 300512
GLENWOOD, UT 84730 COMPANIES AFFORDING COVERAGE
COMPANY National Farmers Union Property and Casualty
INSURED 0O-8080918 A
NUNN TELEPHONE COMPANY COMPANY National Farmers Union Standard Insurance Company
B
PO BOX 148
NUNN, CO 80648-0148 COMPANY
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 CONSTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTRAIN.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 OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
DATE (Ml/DD/YYYY) DATE EVI/DD/YYYY)
LTR
B GENERAL LIABILITY 2RU0162074 01/01/2003 01/01/2004 GENERAL AGGREGATE $
®COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGC $ 2,000,000
DO CLAIMS MADE ®OCCURRENCE PERSONAL & ADV INJURY $ INCLUDED
EI 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 2RU0162074 01/01/2003 01/01/2004 COMBINED SINGLE LIMIT $ 1,000,000
®ANY AUTO BODILY INJURY (Per Peraao)
❑ALL OWNED AUTOS BODILY INJURY (Pe. acciaeed $
❑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 2C00250132 01/01/2003 01/01/2004 EACH OCCURRENCE $ 2,000,000
®UMBRELLA FORM AGGREGATE $ 2,000,000
❑OTHER THAN UMBRELLA FORM $
WORKERS' COMPENSATION AND STATUTORY LIMITS
EMPLOYERS' LIABILITY EACH ACCIDENT $
DISEASE - POLICY LIMIT $
THE PROPRIETOR/ DISEASE - EACH EMPLOYEE $
PARTNERS/EXECUTIVE ❑INCL.
OFFICERS ARE: 0 EXCL.
OTHER
B REAL AND PERSONAL PROPERTY 2RU0162074 01/01/2003 01/01/2004 ALL OTHER PERIL $ 1,632,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
Certificate Holder CANCELLATION.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE
THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 T
BOARD OF COUNTY COMMISSIONERS CERTWICATE HOLDER NAMED TO THE LEFT BUT FAILURE TOMP 2003-0400
COUNTY OF WELD OBLIGATION OR IABI ISY OF ANY KIND UPON THE COMPANY,II
915 TENTH ST.
G REELEY, CO 80631 C rr
Authorized Representative: ,cle___7
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