HomeMy WebLinkAbout20002942.tiff ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE
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PRODUCER (303)776-5122 (303)776-5495 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMAT ON
FNB Insurance Group, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND R
512 4th Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BEL W.
P.O. Box 847
Longmont, CO 80502-0847 INSURERS AFFORDING COVERAGE
INSURED Bowen Enterprises INSURERA: American E & S/Landmark American Its. Co.
Centennial Backhoe INSURER B: Deep South/Clarendon National Ins. Co.
PO Box 184 INSURER C: Pinnacol
Longmont, CO 80502 INSURER D:
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 9UCf'
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE IMNVDD/YYI DATE IMNVDDmI
GENERAL LIABILITY PENDING 11/09/2000 11/09/2001 EACH OCCURRENCE $ 1,000,00
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) $ 100,00
CLAIMS MADE X OCCUR MED EXP(Any one person) $ 5,00
A I PERSONAL S ADV INJURY $ 1,000,00
GENERAL AGGREGATE $ ,000,00
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $ 000,00
POLICY PRO- LOC
JECT
AUTOMOBILE LIABILITY DMA000000948 11/09/2000 11/09/2061 COMBINED SINGLE LIMIT
ANY AUTO (Ea accident) $ 1,000,00
ALL OWNED AUTOS
BODILY INJURY $
X SCHEDULED AUTOS (Per person)
B --_
X HIRED AUTOS
BODILY INJURY $
X NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG E
EXCESS LIABILITY EACH OCCURRENCE $
OCCUR CLAIMS MADE AGGREGATE $
$
DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND 1085770 04/01/2000 04/01/2001 I TORY LIMITS I EN _
EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ 100,00
C E.L.DISEASE-FA EMPLOYE- $ 100,00
E.L.DISEASE-POLICY LIMIT I$ 500,000
THER PENDING 11/09/2000 11/09/2001 Owned as per Schedule
contractors Equipment
A -$250 ded Rented $50,000 any item
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER I I ADDITIONAL INSURED;INSURER LETTER: CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFOR THE
EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO P PAIL
Weld County 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Dept of Public Health & Environment BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILE'Y
1555 North 17th Avenue OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES.
L .
Greeley, CO 80631 AUTHORIZED REPRESENTATIVE p' G?.
Beth Shipp/BETH >1-6.
ACORD 25-S(7197) nArnon rnoondPATInM 4988
1.104501'f e ',ICM-I
11-da- 2000-2942
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