HomeMy WebLinkAbout20001209 ACORR.. CERTIFICATE OF LIABILITY INSURANCEOPID ZB °ATEIMM/°°"Y,
CONWE01 04/18/00
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Lockton Companies of Colorado HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
4500 Cherry Creek Dr. S. , #400 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver CO 80246-1532 COMPANIESAFFORDING COVERAGE
COMPANY
PhoneNo. 303-753-2000 FaxNo. 303-753-2099 A TRANSPORTATION INSURANCE CO.
INSURED COMPANY
B TRANSCONTINENTAL INS. CO.
Continental West
Constructors, Inc. COMPANY
CWC North, LLC C TIG INSURANCE COMPANY__
1703 E. 18th St. #2B M6 COMPANY - -- - 1-_
Loveland CO 80538 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 POI ICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS '
LTR DATE(MM/DENY) DATE(MM/DDNY)
L.l
GENERAL LIABILITY GENERAL AGGREGATE I $ 2,000, 000
A X COMMERCIAL GENERAL LIABILITY CO1056448099 01/01/00I 01/01/01 PRODUCTS-COMP/OPAGG $ 2,000, 000
CLAIMS MADE X I OCCUR PERSONAL B ADV INJURY $ 1,000, 000
OWNER'SS CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000, 000
X Per Project Agg. FIRE DAMAGE(Any one fire) II $ 300,000
MEDEXP(Any one person) $ 10, 000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
B XI ANY AUTO BUA1063856290 01/01/00 01/01/01
ALL OWNED AUTOS —
BODILY INJURY
SCHEDULED AUTOS ' (Per person) $
X i HIRED AUTOS
- -__ BODILY INJURY $
X NON-OWNED AUTOS (Per accident)
---- - ------_ PROPERTY DAMAGE $
GARAGE LIABILITY - AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY
EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $ 8,000,000
C X 1 UMBRELLA FORM XLB9234022 I 01/01/00 01/01/01 AGGREGATE k$.8,000, 000
I OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND X WC STATU OTH-
TORY LIMITS ER
EMPLOYERS'LIABILITY EL EACH ACCIDENT Ls100,000
THE PROPRIETOR/
B X INCL WC2023135774 01/01/00 01/01/01 EL DISEASE POLICYLIMIT $ 500,000
PARTNERS/EXECUTIVE
- ----- _.__
'., OFFICERS ARE'. EXCL EL DISEASE-EA EMPLOYEE I $ 100,000
OTHER I
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
Weld County, Colorado by & through the Board of County Commissioners of the
County of Weld, its officers & employees are included as Additional Insured
on the General Liability.
CERTIFICATE HOLDER '.CANCELLATION
WELCO10 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAI
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Weld County Engineering BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
Department
PO Box 758 OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES.
Greeley CO 80632r /.
) "nn
ACORD 25-S(f/95)
6)4424,740i t O_S-Oi-02000 2000-1209
Certificate of Insurance
t THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFICATE HOLDER. THIS CERTIFICATE IS NOT AN
INSURANCE POLICY AND DOES NOT AMEND,EXTEND,OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW.
This is to Certify that
FV-7-ALMONT INDUSTRIES, INC. +,_tom
Name and LIBERTY at
ATTN: KATHY JOHNSON 4-4--- address of MUTUAL® .
ONE VALMONT PLAZA Insured. •
OMAHA, NE 68154-5215
Is,at the issue date of this certificate,insured by the Company under the policy(ies)listed below. The insurance afforded by the listed policy(ies)is subject to all their terms,exclusions
and conditions and is not altered by any requirement,term or condition of any contract or other document with respect to which this certificate may be issued.
EXP.DATE ---- "—"------
. ❑CONTINUOUS
TYPE OF POLICY ❑ EXTENDED POLICY NUMBER LIMIT OF LIABILITY
® POLICY TERM
WORKERS 1/1/2001 WA1-64D-004195-010 COVERAGE AFFORDED UNDER WC
COMPENSATION LAW OF THE FOLLOWING STATES: EMPLOYERS LIABILITY
INCLUDES OTHER WC2.641-004195-020 AZ, CA, CO, FL, GA, ID, IL, Bodily Injury By Accident
STATES IN, MN, NE, NV, OK, OR, $500,000 Each
ENDORSEMENTS Accident
(EXCEPT MONOPOLISTIC TN, TX, UT, VA Bodily Injury By Disease
STATES)
$500,000 Limit
Liolicy
Bodily Injury By Disease
$500,000 Each
Person
GENERAL LIABILITY General Aggregate-Other than Products/Completed Operations
1/1/2001 RG2-641-004195.030
$2,000,000
IglI
OCCURRENCE Products/Completed Operations Aggregate
$1,000,000
O CLAIMS MADE Bodily Injury and Property Damage Liability
$1,000,000 Ocr
Occurrence
Personal Injury
RETRO DATE $1,000,000 Per Person/
Organization
Other FIRE LEGAL$50,000 Other MED PAY$5,000
AUTOMOBILE LIABILITY 1/1/2001 AS2-641-004195-050
$1,000,000 Each Accident-Single Limit
B.I.and P.D.Combined
® OWNED
Each Person
® NON-OWNED Each Accident or Occurrence
® HIRED
Each Accident or Occurrence
OTHER 1/1/2001
UMBRELLA EXCESS RE1-641-004195-040 $1,000,000 COMBINED SINGLE LIMIT FOR BI& PD
LIABILITY OVER UNDERLYING LIMITS.
ADDITIONAL COMMENTS•It the certificate expiration date is continuous or extended term,you will be notified if coverage is terminated or reduced before the certificate expiration date.
SPECIAL NOTICE-OHIO: ANY PERSON WHO,WITH INTENT TO DEFRAUD OR KNOWING THAT HE IS FACILITATING A FRAUD AGAINST AN INSURER,SUBMITS AN
APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS GUILTY OF INSURANCE FRAUD.
IABOUT THIS MPORTANT NOTICE TO FLORIDA POLICYHOLDERS AND CERTIFICATE HOLDERS : IN THE EVENT YOU HAVE ANY QUESTIONS OR NEED INFORMATION
LOWER RIGHT EHAND CORNER OF THIS CERTIFICATE.E THECO APPNTATROPRIATOE LOCAL SALESO OFFICOUR Lcal_SALES EMAILING ADDRESS MAY ALSO BE OBTAINED BYPCAL LNG THIS4 WHOSE NAME AND TELEPHONE NUMBER APEARS IN "lUfrfy Mutual Group
NOME
OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.) BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL
NOT CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAS
NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO: 30 DAYS
�1AT.r.FY IRRIGATION OF GREELEY 44-8-1
4'1 /J,
ATTN: DARLA A-11 J JUDITH S. O'NEAL/
HOLDER ATE 651 "0" STREET AUTHORIZED REPRESENTATIVE
P.O. BOX 307 �J Overland Park, KS 913-681-1700 03/13/2000
GREELEY, CO 80832 L' OFFICE PHONE NUMBER DATE ISSUED
I
This ci•rl,fica to is executed by LIBERTY MUTUAL GROUP as respects such insurance as is afforded by Those Com panics
15,9 7721 R2
ACORD CERTIFICATE OF LIABILITY INSURANC�PID RS DATE(MnvDDm)
ZBZX 1 04/24/00
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Linden/Bartels & Noe Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
3459 W 20th Street Suite 224 ALTERTHECOVERAGEAFFORDEDBYTHEPOLICIESBELOW.
Greeley CO 80634
Phone: 970-356-1133 Fax:970-356-4088 INSURERS AFFORDING COVERAGE
INSURED INSURERA: Union Insurance
INSURER B: CCIA/Pinnacol Assurance
DZ BZ X-Kavating, Inc. INSURER C:
3933 High Plains Dr. INSURERD:
Berthoud CO 80513 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 POLICY
ATE(MM/DDNY)E DATE EXPIRATION( / M )) LIMITS-
.
TYPE OF INSURANCE POLICY NUMBER
GENERAL LIABILITY EACHOCCURRENCE $'1,000,000
A X COMMERCIAL GENERAL LIABILITY UPK5018996 09/17/99 09/17/00 FIRE DAMAGE(Any one fire) 'b.00,000
I I CLAIMS MADE X I OCCUR MED EXP(Any one person) $ 5,000
PERSONAL&ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000
POLICY PRO- LOC
JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
A ANY AUTO UPK5018996 09/17/99 09/17/00 (Ea accident) $ 1,000,000
ALL OWNED AUTOS
BODILY INJURY $
X SCHEDULED AUTOS (Per person)
X HIRED AUTOS
BODILY INJURY $
X NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO EA ACC $
OTHER THAN
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $
OCCUR CLAIMS MADE AGGREGATE $
$
DEDUCTIBLE
$
RETENTION $ $
WORKERS COMPENSATION AND rH-
X TORY LIMITS ER
ER
B EMPLOYERS'u u 48! TY 3329375 ' 05/01/00 " 05/01/01 'E.L.EACH ACCIDENT $ 100000
E.L.DISEASE-EA EMPLOYEE $100000
E.L.DISEASE-POLICY LIMIT $ 500000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER I I ADDITIONAL INSURED:INSURER LETTER: CANCELLATION
WECTYPU SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL
WELD COUNTY PUBLIC 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
WORKS DEPT LEFT,BUT FAILURE TO DO SO SHAL NO OBLIGATION 0 LIABI TY OF
1111 H STREET
GREELEY CO 80632 ANY KIND UPON THE INSURER,ITS A NTS OR EPRBSEN E I David Austin, CIC
5eOR 7/9ja, " ACORD CORPORATION 1988
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