HomeMy WebLinkAbout20010768.tiff ACORD„ CERTIFICATE OF LIABILITY' INSURANCE DATE IMM/DD/TY)
.. _. : ;03/16/2001
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Talbot Insurance Agency, Inc 1 =L1 ' ' 1 ` ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1601 28th Street .. . ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Boulder, CO 80301 I_r-- COMPANIES AFFORDING COVERAGE
g I 7 � 1 O' Compensation 9: , � COMPANY American Com ensation Ins Co
A
INSURED
rm
Island Grove Regional Treatment Cent —/�- t\/L- COMPANY
1140 M Street
COMPANY
C
Greeley CO 80631
COMPANY
D
COVERAGES •
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 OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
LTR DATEIMM/DD/YYI DATEIMM/DD/YYI LIMITS
GENERAL LIABILITY GENERAL AGGREGATE $
COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $
CLAIMS MADE OCCUR PERSONAL&ADV INJURY $
OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $
FIRE DAMAGE(Any one tire) 9
MED EXP(Any one person)
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
ANY AUTO 8
ALL OWNED AUTOS
BODILY INJURY 5
SCHEDULED AUTOS (Per person)
HIRED AUTOS
BODILY INJURY 5
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE 6
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT 5
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT 5
AGGREGATE 5
EXCESS LIABILITY EACH OCCURRENCE $
UMBRELLA FORM AGGREGATE
_ OTHER THAN UMBRELLA FORM $
A WORKERS COMPENSATION AND ACCO0040795 10/01/2000 10/01/2001 X. RORVLIMITS I0T
EMPLOYERS'LIABILITY EL EACH ACCIDENT 5100, 000
THE PROPRIETOR/ X INCL EL DISEASE-POLICY LIMIT 5 500, 000
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL I EL DISEASE-EA EMPLOYEE 5100, 000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
Certificate Holder shall read: Weld County Colorado, by and through the Board of County Commissioners of
Weld County, its employees and agents
FAX Insured: Kathryn 970-356-1349
CERTIFICATE HOLDER CANCELLATION
Weld County Colorado 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
915 10th Street 3 0 DAYS WRITTEN NOTICE TO THE CERT�arnrc un�nco R Arm m ..._ .ar
l0 days notice for non-payment
FAILURE TO MAIL SUCH NOTICE SHALT n c
Greeley CO 80632 OF ANY KIND UPON THE COMPANY, 2001-0768 _
AUTHORIZED � Y
REPRESENTATIVE
{
ACORD 2S-511135# a ACORD CORPORATION 4988;
@ds#2430895 co, 'i1/ age-ix/et,
Hello