HomeMy WebLinkAbout972050.tiff AIDIII1II® CERTIFICATE OF INSURANCE os/oi�9
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Ins . Inc . ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P. O. BOX 578 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
4687 W. 18th Street COMPANIES AFFORDING COVERAGE
Greeley, CO 80632
COMPANY
ATravelers Insurance
INSURED
COMPANY
Hall Irwin ConstructionBCIGNA
P.O. Box 659 F COMPANY ;q r-
Greeley, CO 80632
COMPANY
I D J
COVERAGES C.
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR tNE 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 POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE(MM/DD/YY) DATE(MIN DOM)
A GENERAL LIABILITY 263P1116 08/01/97 08/01/98 GENERAL AGGREGATE $2 , 000, 000
X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGO$2 , 000, 000
CLAIMS MADE X OCCUR PERSONAL&ADV INJURY $1, 000, 000
_ OWNER'S B CONTRACTOR'SPROT EACH OCCURRENCE $1, 000, 000
X PD Ded: 5, 000 FIRE DAMAGE(Any one fire)$ 100, 000
MED EXP(Any one person) $ 5, 000
A AUTOMOBILE LIABILITY 263P1116 08/01/97 08/01/98 COMBINED SINGLE LIMIT $1, QQQ, QQQ
X ANY AUTO
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per person) $
HIRED AUTOS
BODILYcci INJURY $
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 $
UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELLA FORM $
B WORKERS COMPENSATION AND NWCC42377223 07/01/97 07/01/98 X STATUTORY LIMITS
EMPLOYERS'LIABILITY 100, 000
EACI-I ACCIDENT $
THE PROPRIETOR/ X INCL DISEASE-POLICY LIMIT $500, 000
PARTNERS/EXECUTIVE ---
OFFICERS ARE: EXCL DISEASE-EACH EMPLOYEE $100, 000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
PROJECT: WELD COUNTY NORTH JAIL COMPLEX-SITE IMPROVEMENTS
ADDITIONAL INSUREDS (AS RESPECTS THIS PROJECT UNDER THE GENERAL LIABILITY)
(See Attached Schedule. )
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
BOARD OF WELD COUNTY EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
COMMISSIONERS 1 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
915 10TH STREET BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
GREELEY, CO 80631 0 ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
/AUT ORIZED REPRESENT TI
ACORD2S•S(3/93)1 of 2 #S90535/M90523 RKS o<
972050
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DESCRIPTIONS (Continued from page 1.)
WELD COUNTY, THE ENGINEER AND HISD CONSULTANTS, AND EACH OF THEIR
OFFICERS, AGENTS, AND EMPLOYEES.
CISGEM2L2(3/93?2 m2 #590535/M90523
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