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Home My WebLink About20013468.tiff ACORD„ CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYI ....12/12/2001 PRODUCER (303)824-6600 FAX (303)370-0118 THIS CERTIFICATE IS ISSUED AS A MATTER:OF INFORMATION Moody Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 3773 Cherry Creek North Drive ALTER THE COVERAGE AFFORDED BYJNE POLICIES BELOW. Suite 800 I r C_� Denver, CO 80209-3804 INSURERS AFFORDING COVERAGE INSURED Quality Paving Company INSURER A'. Travelers Propertf:Co ual ty PO Box 519 INSURER B-. American Dynasty "- --. Henderson, CO 80640-0519 INSURER C. Pinnacol Assurance INSURER D: St Paul Companies 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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTRDATE(MMIDD/YY) DATE IMMIDD/YY) GENERAL LIABILITY DTC0754G611STIA01 12/01/2001 12/01/2002 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY FIREDAMAGE(Anyonefre) $ 300,000 CLAIMS MADE X OCCUR MED EXP(Any one person) $ 5,000 A X Job Site Pollution PERSONAL a.ADV INJURY $ 1,000,000 X Blkt Addtl Insured GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 POLICY n PROCT pi LOC JE AUTOMOBILE LIABILITY DT810754G6115TIL01 12/01/2001 12/01/2002 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) A X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per acode acadenp X Deductibles Vary PROPERTY DAMAGE $ X Blkt Addtl Insured (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY' AGG $ EXCESS LIABILITY TUU3579386 12/01/2001 12/01/2002 EACH OCCURRENCE $ 5,000,000 X I OCCUR CLAIMS MADE AGGREGATE $ 5,000,000 B $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND 2288480 12/01/2001 12/01/2002 I roariAnTn11$I X I OER EMPLOYERS'LIABILITY E .EACH ACCIDENT $ 500,000 EL.DISEASE-EA EMPLOYEE $ 500,000 E .DISEASE-POLICY LIMIT $ 500,000 THER INLAND MARINE/BINDER 12/01/2001 12/01/2002 Limit $6,037,410;$2,500 Ded D CQontractors Equipment Limit $250,000; $2,500 Ded Leased/Rented Equip DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Re: 2001 Slurry Seal Project Certificate Holder is named as Additional Insured under the General Liability as respects work performed by Named Insured. CERTIFICATE HOLDER I I ADDITIONAL INSURED;INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, The Board of Weld County Commissioners BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 915 10th Street OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. Greeley, CO 80632 AUTHORIZED REPRESENTATIVE Consie Hum, CISR/CAH 776-6,10C- ACORD 25-5, (7y ©ACORD CORPORATION 1988 ('€wse4 "L-� /off /�- C 2001-3468 Hello