HomeMy WebLinkAbout20002471.tiff PRODUCER
CERTIFICATE OF LIABILITY INSURANCE,PDD 4 I DATE
09/26 00
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
The Linden Co ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDE .THIS CERTIFICATE DOES NOT AMEND EX ND OR
4100 E. Mississippyi Ave, #900 ALTER THE COVERAGE AFFORDED BY THE POLIC E9 BELOW.
Denver CO 80246
Phone: 303-756-6700 Fax:303-756-7700 INSURERS AFFORDING COVERAGE
INSURED
INSURER A: St. Paul Fire & Marine
INSURER B: Pinnacol Assurance
Varra Companies, Inc. INSURER C:
P.O. -Box 2049
Broomfield CO 80038 wsuRERD:
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.
INSH
lTR TYPE OF INSURANCE POLICY NUMBER I DATE(MM/DHD/i)E PDATE(MMDIHDAN LIMITS
GENERAL LIABILITY
EACH OCCURRENCE $ 1000000
A X COMMERCIAL GENERAL LIABILITY 1(808301369 10/01/00 10/01/01 FIRE DAMAGE(Any one fire) $ 50000
I CLAIMS MADE I X I OCCUR
MED EXP(Any one Person) $ 5000
PERSONAL 8,ADV INJURY $ 1000000
GENERAL AGGREGATE $2000000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMP/OP AGG $2000000
POLICY X .78f LOC
AUTOMOBILE LIABILITY
COMBI
A X ANY AUTO 8808301369 10/01/00 10/01/01 (Ea acodent)INGLELIMIT 81000000
ALL OWNED AUTOS
SCHEDULED AUTOS
(Per person)
BODILY INJURY
X HIRED AUTOS $
X NON-OWNED AUTOS BODILY INJURY
(Per accident) $
PROPERTY DA MAGE $
GARAGE LIABILITY (Per accident)
ANY AUTO
AUTO ONLY-EA ACCIDENT $
OTHER THAN EA ACC $
AUTO ONLY:
EXCESS LIABILITY AGG $
EACH OCCURRENCE $ 1000000
A X I OCCUR CLAIMS MADE 8808301369 10/01/00 10/01/01 AGGREGATE
$ 1000000
X DEDUCTIBLE $
RETENTION $ 10,000 $
WORKERS COMPENSATION AND $
WCSIAIU- OIH-
B EMPLOYERS LIAB!LT' X TORY LIMITS[ ER
3248544 10/01/00 10/01/01 EL.EACHACCIDENr $ 100000
E.L.DISEASE-EA EMPLOYEE $ 100000
OTHER E.L.DISEASE.POLICY LIMIT $ 500000
A Leased/Rented 0808307896 10/01/00 10/01/01 Max An
Equipment Y
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS One Item 300,000
ALL OPERATIONS - NELSON ROAD, PIT #13, LONGMONT, COLORAD
CERTIFICATE HOLDER I I ADDITIONAL INSURED;INSURER LETTER: _ CANCELLATION
WELDC-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
WELD COUNTY IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
915 10TH STREET REPRESENTATIVES.
GREELEY CO 80631 AUTHORIZED REPRESENTATIVE Y,r�
! Frank F. Crowe " /�`�"'^'• a
ACORD 25-5(7/97) �I
Ct7?sei7/ die/70/11, /D-//-OP
2000-2471
ACORD CERTIFICATE OF LIABILITY INSURANC PID DD 4 DATE
09/26%0
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
The Linden Company HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
4100 E. Mississippi Ave, #900 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver CO 80246
Phone: 303-756-6700 Fax:303-756-7700 INSURERS AFFORDING COVERAGE
INSURED INSURER A: St. Paul Fire & Marine
INSURER B: Pinnacol Assurance
Varra Companies, Inc. INSURER C.
P.O. Box 2049 INSURER D:
Broomfield CO 80038
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 L TYPE OF INSURANCE POLICY NUMBER POLICY
ATE(MWDDD!YY)E POLICY
LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1000000
A X COMMERCIAL GENERAL LIABILITY KK08301369 10/01/00 10/01/01 I FIREDAMAGE(Anyonefire) $ 50000
CLAIMS MADE X OCCUR MED EXP(Any one person) $ 5000
PERSONAL&ADV INJURY $ 1000000
GENERAL AGGREGATE $2000000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2000000
POLICY X ! C
LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
A X ANY AUTO KK08301369 10/01/00 10/01/01 (Eaaccident) $ 1000000
ALL OWNED AUTOS BODILY INJURY
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 $ 1000000
A X I OCCUR CLAIMS MADE ICK08301369 10/01/00 10/01/01 AGGREGATE $ 1000000
X DEDUCTIBLE $
RETENTION $ 10,000 $
WC SIAIU- U
WORKERS COMPENSATION AND X TORY LIMITS ER
B EMPLOYERS LIABILTV 3248544 10/01/00 10/01/01 E.L.EACH ACCIDENT $ 100000
E.L.DISEASE-EA EMPLOYEE $ 100000
E DISEASE-POLICY LIMIT $ 500000
OTHER
A Leased/Rented CK08307896 10/01/00 10/01/01 Max Any
Equipment One Item 300,000
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
ALL OPERATIONS - DAKOLIOS PIT, ROAD #13, LONGMONT, COLORADO
CERTIFICATE HOLDER I ADDITIONAL INSURED;INSURER LETTER: CANCELLATION
WELDC-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
WELD COUNTY
915 10TH STREET REPRESENTATIVES.
GREELEY CO 80631 AUTHORIZED REPRESENTATIVE
Frank F. Crowe a
ACORD 25-S(7/97) " CORD CORPORATION 1991
e0/1- en /D-//-OD
' MARSH USA INC. CERTIFICATE OF INSURANCE CERTIFICATE NUMBER
PRODUCER NYC-000494065-00
Marsh USA nC. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
Attention Rosalie Belluccia NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE
POLICY.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE
TEL:212 345 5255, FAX:212 345 5991
1166 Avenue of the Amiercas,42nd Floor AFFORDED BY THE POLICIES DESCRIBED HEREIN.
New York, NY 10036-2774 COMPANIES AFFORDING COVERAGE
10600-ICI R-RENEW-99-00 COMPANY
-- -- -- A OLD REPUBLIC INSURANCE COMPANY
INSURED - - - -- --- -- - -
COMPANY
Tele-Vue Systems, Inc. B NATIONAL UNION FIRE INS CO.
4700 S. Syracuse Street,Suite 1100
Denver,CO 80237
COMPANY -
C N/A
COMPANY
D
COVERAGES
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY
PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,CONDITIONS AND EXCLUSIONS OF SUCH POLICIES.LIMITS SHOWN
MAY HAVE BEEN REDUCED BY PAID CLAIMS.
Co -
LTR TYPE OF INSURANCE POIJCY NUMBER I POLICY EFFECTIVE r POLICY EXPIRATION
DATE(MM/DDNY) DATE(M I LIMITS
A I GENERAL LIABILITY IMWZY 54957 110/15/99
10/15/02 j PRODUCTS-CO GATE $
X� COMMERCIAL GENERAL LIABILITY IGENERAL
I
I PRODUCTS-COMP/OP AGG1$ 2,500,000
I-
I- ] CLAIMS MADE I X I OCCUR
1 PERSONAL&ADM INJURY I $ 2,500,000
F
OWNER'S 8 CONTRACTOR'S PROT r-- _
EACH OCCURRENCE L$- 2,500,000
- -
- - - _- 10/15/99 FIRE DAMAGE(Any one fire) $ — -- —
A AUTOMOBILE LIABILITY IMWIB 17862 I MED EXP(Any one person) $
- 10/15/02
_- ANY AUTO I COMBINED SINGLE LIMIT I $ 2,500,000
•
ALL OED AUTOS — - .— — _- -- -_—._ --- _
SCHEDULED AUTOS (PeDI LersoNny RV $
I_ HIRED AUTOS -_. —— __ -- — J
HNON-OWNED AUTOS BODILY INJURY
7 I (Per accident) $
I
11 — _ _ — — — — t
_ -� _ PROPERTY DAMAGE $
GARAGE LIABILITY
-- ANY AUTO _AUTO ONLY_EA ACCIDENT $
I OTHER THAN AUTO ONLY.
r I_ _ EACH ACCIDENT $
XI
B EXCESS LIABILITY BE 357 8851 AGGREGATE $
10/15/99 10/15/01 EACH OCCURRENCE
- UMBRELLA FORM - - -- 4$ - _ 1,000,000
AGGREGATE_ _ $ 1,000,000
OTHER THAN UMBRELLA FORM $._.
A I WORKERS COMPENSATION AND MWG 10749300 $
EMPLOYERS'LIABINry 01/01/00 10/15/00' Va STA7U- I IOTH- -
X TORY LIMITS ER
THE PROPRIETOR/ EL EACH ACCIDENT $ 1,000,000
INCL' PARTNERSIEXECUTIVE - I EL DISEASE-POLICY LIMIT $ 1,000,000
OFFICERS ARE. I X I EXCL
OTHER I EL DISEASE-EACH EMPLOYEEI$ 1,000,000
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS(LIMITS MAY BE SUBJECT TO DEDUCTIBLES OR RETENTIONS)
Term of Contract:8/16/00-8/15/2012. The Certificate Holder is added as an Additional Insured as required by written contract or lease agreement.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,
Weld County THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL
DAYS WRITTEN NOTICE TO THE
CERTIFICATE HOLDER NAMED HEREIN,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
Board of County Commissioners
Attention County Clerk LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE,ITS AGENTS OR REPRESENTATIVES.
915 10th Street
Greeley,CO 80632
MARSH USA INC.
BY: Lisa Trimble ���Th. i �.J CA
MM1(9/99) VALID AS S OF: 09/26/00
't- - OCI
/v////3C:CC)
Hello