HomeMy WebLinkAbout20000231 ACORP. CERTIFICATE OF LIABILITY INSURANC SR RK DATE(MM/DDIVY)
C-1 01/07/00
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Community First Insurance ' ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Agencies, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
4812 South College Ave ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins CO 80525
Phone: 970-223-4744 Fax: 970-223-0891 • . ... INSURERS AFFORDING COVERAGE
INSURED INSURER A: Valley Forge
INSURER B: Federal Insurance Company
Ward Construction INSURER C: Continental Casualty
Franklin Ward
P.O. Box 265 INSURERD: National Fire Ins. Co.
Loveland CO 80539
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 EXPIRATION
LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/VY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE _1 $ 1,000,000
-_r
A X COMMERCIAL GENERAL LIABILITY Cl 23424677 • 01/01/00 01/01/01 FIRE DAMAGE(Any one fire) • $ 50,000
JCLAIMS MADE f X OCCUR _MED EXP(Any one person) $ 5,000
• PERSONAL BADV INJURY I $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
EPLIIMMIT APPLIES LPER: PRODUCTS-COMP/OP AGG ' $ 1,000,000
GEN'L AGGREGATE
POLICY JECT I
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
C X ANY AUTO C1 23424680 01/01/00 01/01/01 (Ea accident) '. $ 1,000,000
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 I $•
-
ANY AUTO • ' OTHER THAN EA ACC $
• AUTO ONLY: AGG • $
EXCESS LIABILITY EACH OCCURRENCE $2,000,000
B XOCCUR I CI CLAIMS MADE 79428343 01/01/00 '. 01/01/01 AGGREGATE I $ 2,000,000
$
DEDUCTIBLE I I $
RETENTION $ $
WLSIAIU- UIH-
WORKERS COMPENSATION AND TORY LIMITS ER
D EMPLOYERS'LIABILITY WCC 1 23424694 01/01/00 01/01/01 E.L.EACH ACCIDENT $ 500,000
E.L.DISEASE-EA EMPLOYEE $ 500,000
E.L.DISEASE-POLICY LIMIT $ 500,000
OTHER
•
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
The Blanket Additional Insured Endorsement G17957-B applies to this
Certificate Holder but NOT with respect to Workers Compensation.
CERTIFICATE HOLDER N ADDITIONAL INSURED;INSURER LETTER: CANCELLATION
GENERAL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL
GENERAL SERVICES DIRECTOR 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
WELD COUNTY LEFT,BUT FAILURE TO DO SO SHALL I OSE NO OBLIGATION OR LIABILITY OF
PO BOX 758
GREELEY CO 80632 ANY KIND UPON THE INSURER,ITS AG NTS OR REPRESENTATIVES.
•
Keith BeT....p
ACORD (1I971 �_ /_ /7-4000
[�C/J �-� G`f�6�- 2000-0231
ACORD CERTIFICATE OF LIABILITY INSURANC SR RK DATE(MM/DD/YY)
K-1 01/10/00
PRODUCER - - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Community First Insurance - ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Agencies, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
4812 South College Ave ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins CO 80525 .:7 INSURERS AFFORDING COVERAGE
Phone: 970-223-4744 Fax: 970-223-0891
INSURED INSURER A: Transcontinental
- iwsORER B: Transportation Ins. Co.
Jake Kauffman and Son, Inc. 1
Frank Kauffman INSURER C:
808 S. County Rd. 9E INSURER D:
Loveland CO 80537
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 EFFECTIVE POLICY EXPIRATION
LTR TYPE OF INSURANCE POLICY NUMBER DATE(MWDD/YY) DATE(MM/DD/YY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A COMMERCIAL GENERAL LIABILITY C 131565872 12/23/99 12/23/00 FIRE DAMAGE(Any one fire) 'IS 50,000
I CLAIMS MADE OCCUR! MED EXP(Any one person) ' S 5,000
J ,. I PERSONAL BADV INJURY I S 1,000,000
GENERAL AGGREGATE S 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PERT PRODUCTS-COMP/OP AGG S 1,000,000
POLICY 1 PRO- --1 LOC
1 JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
B I ANY AUTO C 1031552796 12/23/99 12/23/00 (Ea accident)
' S1,000,000
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS (Per person)
HIRED AUTOS BODILY INJURY S
NON-OWNED AUTOS (Per accident) - -_-
- PROPERTY DAMAGE $
�I (Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S
j ANY AUTO OTHER THAN EA ACC I $
1 AUTO ONLY: AGG I S
EXCESS LIABILITY EACH OCCURRENCE 51,000,000
B _ OCCUR Li CLAIMS MADE Cl 31552801 '� 12/23/99 12/23/00 AGGREGATE $ 1,000,000
DEDUCTIBLE S
RETENTION S $
Wt.JIAIU- IOtH-I
WORKERS COMPENSATION AND TORY LIMITS ER
EMPLOYERS'LIABILITY
B WC 1 36347844 12/23/99 I., 12/23/00 E.L.EACH ACCIDENT Ss 100,000
1 E.L.DISEASE-EA EMPLOYE $ 100,000
E.L.DISEASE-POLICY LIMIT I $ 500,000
OTHER I
DESCRIPTION OF OPERATIONS/LOCATIONSNE.HICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
The following is named as an additional insured as respects the activities
of the named insured for general liability and automobile liability: Weld
County, Colorado, by and through the Board of County Commissioners of Weld
County, its employees and agents. This endorsement does not apply to
workers compensation coverage.
CERTIFICATE HOLDER ADDITIONAL INSURED:INSURER LETTER: CANCELLATION
WELDCOU SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE I ING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE 0 THE CERTIFICATE HOLDER NAMED TO THE
WELD COUNTY, COLORADO LEFT,BUT FAILU E 0 SO S L M ENO OBLIGATION OR LIABILITY OF
915 10TH STREET
GREELEY CO 80631 ANY KIND UP URER,I GEN EPRESENTATIVES.
Keith Behiner
A ORD 25-S(7/97 ACORD CORPORATION 1988
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