HomeMy WebLinkAbout20013047 Client# : 23903 UNITEPOW
acnxnm CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/Y1)
10/09/01
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Insurance Network of America ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
107 West Crockett HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
LaGrange, TX 78945-2638 r
979 968-4622 ', r' 1 - INSURERS AFFORDING COVERAGE
INSURED INSURER A:St . Paul Fire & Marine
United Power, Inc . I INSURER BNatiOnal Union Fire
18551 East 160th Avenue
PO Box 929 INSURER C:
Brighton, CO 80601 INSURER D:
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 - POLICY EFFECTIVE POLICY E)PIRATION
ITR TYPE OF INSURANCE POLICY NUMBER DATE(MFECTIVY) DATE(MM/DO/YY) LIMITS
A GENERAL LIABILITY 602NB2902 , 09/01/01 09/01/02 EACH OCCURRENCE $2, 000, 000
X,'I COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one tire) $500 , 000
I CLAIMS MADEi Xl OCCUR MEDEXP(Any one person) $10, 000
X PD Ded: 1, 000 PERSONAL BADV INJURY $2 , 000, 000
GENERAL AGGREGATE $
GEN'L AGGREGATE LIMITAPPLIES PER: PRODUCTS-COMP/OP AGO $2, 000, 000
POLICY[ JEOT , LOC
A AUTOMOBILE LIABILITY 602NB2902 09/01/01 09/01/02 COMBINED SINGLE LIMIT
X ANY AUTO (Ea accident) $1, 000, 000
ALL OWNED AUTOS
BODILY
URV $
SCHEDULED AUTOS i (Per person)
X HIRED AUTOS I
BODILY INJURY
X I NON-OWNED AUTOS (Per accident) $
-- - PROPERTY DAMAGE
(Per accident) $
GARAGE LIABILITY
AUTO ONLY-EA ACCIDENT $
7 ANY AUTO
-I, OTHER THAN EA ACC $
AUTO ONLY: AGO $
B I EXCESS LIABILITY BE8718347 09/01/01 09/01/02 EACH OCCURRENCE s25, 000, 00C
X OCCUR j CLAIMS MADE AGGREGATE $25, 000, 00C
$
DEDUCTIBLE
X, RETENTION $10000 $
WORKERS COMPENSATION AND WC STATU- 0TH-
EMPLOYERS'LIABILITY --_ TORYI IMITS _ER_
E.L.EACH ACCIDENT $
E.L.DISEASE-EA EMPLOYE $
E.L.DISEASE-POLICYLIMI $
OTHER
I
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER I ADDmONALINSURED;INSURER LETTER CANCELLATION
SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BECANCELLED BEFORETHE E)eIRATON
Weld County of Colorado DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TOMAILI O DAYS WRITTEN
P.O. Box 758 NOTICETOTHE CERTIFICATE HOLDERNAMED TOTHE LEFT,BUT FAILURE TO DO SO SHALL
Greely, CO 80621-0758 IMPOSE NO OB LIGATION OR LIABILITY OFANYKIND UPON THE INSURERITSAGENTS OR
REPRE ES.
AUTH EPRESEI$�Ry��,_� �.
ACORD2 -S 7/97) f 2 #596892/M96878 631 2001-3047
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IMPORTANT
If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer,and the certificate holder, nor does it
affirmatively or negatively amend, extend or after the coverage afforded by the policies listed thereon.
ACORozs-s(7/97)2 of 2 #S96892/M96878
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