HomeMy WebLinkAbout20030273.tiff ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YY)
01/18/03
PRODUCER LIC AN/A 1-303-757-5475 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
CIESA ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
3665 Cherry Creek North Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver, Co 80209 INSURERS AFFORDING COVERAGE
INSURED
Town of Kersey INSURER A:Landmark American Insurance Company
INSURER B:
332 Third Street, Box 657
INSURER O.
Kersey, CO 80644 INSURERD:
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 I POLICY EFFECTIVE POLICY EXPIRATION
I TA TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YYI DATF(MM/DD/YYI I LIMITS
A GENERAL LIABILITY ALA 100066 01/01/03 01/01/04 EACH OCCURRENCE $5,000,000
COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) $5,000,000
X I CLAIMS MADE OCCUR ' MED EXP(Any one person) $
X l$1Dm E&O Aggregate PERSONAL ADV INJURY $ 5,000,000
GENERAL AGGREGATE $
GEN'L AGGREGATE LIMITAPPLIES PER: PRODUCTS-COMP/OP AGG $ 5,000,000
POLICY PRO-
A AUTOMOBILE LIABILITY ALA 100066 01/01/03 01/01/04
'n ANY AUTO •
COMBINED� t SINGLE LIMIT $1,500,000
)
:ALL OWNED AUTOS
SCHEDULED AUTOS BODILYINJURY
I ��' (Per person)
I $
I per HIRED AUTOS
NON-OWNED AUTOS • (PerBO ac INJURY
(Per accident) $
•
PROPERTY DAMAGE
(Per accident) $
GARAGE LIABILITY
GARAGE AUTO ONLY-EA ACCIDENT $
ANY AUTO
OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $
I OCCUR 1 CLAIMS MADE AGGREGATE $
DEDUCTIBLE $
$
RETENTION $ .
$
WORKERS COMPENSATION AND WC FATS
IOTH-
EMPLOYERS'LIABILITY TO LIMITS VP
-
EMPLOYERS' EACH ACCIDENT $
E.L.DISEASE-EA EMPLOYEE,$
E.L.DISEASE- V LIM(J, $ --, -
OTHER _ _
Fn
NJ : Cl
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSKINS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS r' -^- r-
As respects law enforcement agreement covering activities of - `'•
Town's police while ?^-
performing traffic enforcement on Kersey
Portion.
V
CERTIFICATE HOLDER Y (ADDITONAL INSURED;INSURER LETTER: CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
WELD COUNTY COMMISSIONERS DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
Dale Hall NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
P O 758 -L1772-inde /yJ IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
n', REPRESENTATIVES.
GREELEY, .80632 �_O� AUTHORIZED REPRESENTATIVE
USA icc _tt yac .
ACORD 25-S(7/97) cplatt G1�CO3-(far/
932065 @ ACS .3
CIRSA
3665 Cherry Creek North Drive
Denver, CO 80209
USA
WELD COUNTY COMMISSIONERS
Dale Hall
P 0 758
GREELEY, CO 80632
USA
Attached is your requested Certificate of Insurance. Click on the PDF file below to view or
print the certificate.
If you have questions regarding the content of this document, please contact
CIRSA at (303) 757-8950 or (800) 228-7136.
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