HomeMy WebLinkAbout951666.tiffAC:OOitIL
ERTIF
LATE OF INSURANC
ISSUE DATE (MM/DD/YY)
10—JUL-1995
Willis Corroon Corporation of Maryland
10 North Park Drive
Hunt Valley MD 21030
1410) 527-1200
Contact : Kimberly S. Suarez—Murias
INSURED
30242 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
Western Mobile Inc. and its subsidiaries
Mobile Premix
1400 W. 64th Avenue
Denver CO 80221
COMPANIES AFFORDING COVERAGE
COMPANY National Union Fire Insurance Co of
LETTER A
Pittsburgh PA
COMPANY
LETTER B
COMPANY
LETTER a
COMPANY
LETTER D
COMPANY
LETTER E
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR T POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPETO 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
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MM/DD/YY)
POLICY EXPIRATION
DATE (MM/DO/YY)
LIMITS
A
A
GENERAL LIABILITY
X
X
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE X OCCUR.
OWNER'S & CONTRACTOR'S PROT.
AUTOMOBILE LIABILITY
X ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
X HIRED AUTOS
X NON -OWNED AUTOS
GARAGE LIABILITY
RMGL1212727
RMCA1351224
15-JUL-1995
15-JUL-1995
15-JUL-1996
15-JUL-1996
GENERAL AGGREGATE
PRODUCTS-COMP/OP AGG
PERSONAL & ADV. INJURY
$ 2,000,000
$ 2,000,000
EACH OCCURRENCE
FIRE DAMAGE (Any one tire)
MED. EXPENSE (Any one person
COMBINED SINGLE
LIMIT
BODILY INJURY
(Per person)
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
1 000,000
1,000,000
1,000 000
5,000
1,000,000
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
EACH OCCURRENCE
AGGREGATE
WORKER'S COMPENSATION
AND
EMPLOYERS' LIABILITY
OTHER
RMWC0171732
X STATUTORY LIMITS
15-JUL-1995 15-JUL-1996 EACH ACCIDENT
DISEASE -POLICY LIMIT
1,000,000
$ 1,000,000
DISEASE -EACH EMPLOYEE $ 1,000,000
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/SPECIAL ITEMS
Project: Weld County Road 8
Weld County, Colorado is hereby named as an Additional Insured
CERTIFICATE HOLDER
Weld County Commissioners
915 10th Street
Greeley CO 80632
ACORD 25.8.3
}
sn'1-+-t 7/u /C 3
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
r MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ND UPON THE CO Y, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPPRE
51666
ACOItD. CERTIFICATE
OF INSURANC
ISSUE DATE (MM/OD/YY)
10—JUL-1995
Willis Corroon Corporation of Maryland
10 North Park Drive
Hunt Valley MD 21030
(410) 527-1200
Contact : Kimberly S. Suarez—Murias
INSURED
Western Mobile Inc. and its subsidiaries
Mobile Premix
1400 W. 64th Avenue
Denver CO 80221
30242 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
COMPANY
LETTER
Pittsburgh PA _
COMPANY
LETTER
A National Union Fire Insurance Co of
B
COMPANY
LETTER le
C":
COMPANY
LETTER
COMPANY
LETTER
D
E
COVERAGES
THIS it 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
LT0. TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MM/DD/YY)
POLICY EXPIRATION
DATE (MM/DD/YY)
LIMITS
A
A
OENERAL LIABILITY
X
X
COMMERCIAL GENERAL LIABILITY
1 CLAIMS MADE L XI OCCUR.
OWNER'S & CONTRACTOR'S PROT.
AUTOMOBILE LIABILITY
X ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
X HIRED AUTOS
X NON -OWNED AUTOS
GARAGE LIABILITY
RMGL1212727
RMCA 1351224
15-JUL-1995
15-JUL-1995
15-JUL-1996
15-JUL-1996
GENERAL AGGREGATE
PRODUCTS-COMP/OP AGG.
PERSONAL & ADV. INJURY
EACH OCCURRENCE
FIRE DAMAGE (Any one fire) $ _ 1,000,000
MED. EXPENSE (Any one person) $ 5,000
COMBINED SINGLE
LIMIT
$ _ 2,000,000
$ 2,000,000
s 1,000 000
$ 1,000,000
BODILY INJURY
(Per person)
BODILY INJURY
Per accident)
S
1,000,000
PROPERTY DAMAGE
EXCESS LIABILITY
J
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
EACH OCCURRENCE
AGGREGATE
WORKER'S COMPENSATION
AND
EMPLOYERS' LIABILITY
OTHER
Rivi W C0171732
-JUL-1905
15-JUL-1996
X
STATUTORY LIMITS
1,000,000
1,000,000
1,000,000
EACH ACCIDENT
DISEASE -POLICY LIMIT
DISEASE -EACH EMPLOYEE
DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLESISPECIAL ITEMS
CERTIFICATE:H
DE
Weld County Commissioners
915 10th Street
Greeley CO 80631
ANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH N®TICE SHALL IMPOSE NO OBLIGATION OR
.; LIABILITY OFyJy'I�(IND UPON THE CO Y, ITS AGENTS OR REPRESENTATIVES.
'i?: AUTHORIZED REPRE
...........................
PORATIC
CERTIFICATE WILLIS OF INSURANCE
CORROON OESCRIPTION OF' OPERATION � 7TAf:HM�NT ..
ISSUE DATE (MM/DD/YY)
10-JUL-1995
P'ACa
PRODUCER V.E
30242 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
Willis Corroon Corporation of Maryland
10 North Park Drive
Hunt Valley MD 21030
(410) 527-1200
Contact : Kimberly S. Suarez—Murias
INSURED
Western Mobile Inc. and its subsidiaries
Mobile Premix
1400 W. 64th Avenue
Denver CO 80221
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
COMPANY
LETTER
COMPANY
LETTER
A
B
National Union Fire Insurance Co of
Pittsburgh PA
COMPANY
LETTER C
COMPANY
LETTER D
COMPANY
LETTER E
O
THIS DESCRIPTION OF OPERATIONS ATTACHMENT MAY BE RELIED UPON ONLY IF THE CERTIFICATE
REFERRED TO HEREIN IS ATTACHED HERETO.
r
Certificate Holder : Weld County
General Liability - The Certificate Holder is an Additional Insured solely as
respects work performed by or for the Named Insured in connection with 1992
Chip and Seal Project, provided, however, that a written contract requiring
that the Certificate Holder be an Additional Insured exists.
sr
WILLIS CORROON.25SA
t WILLIS G0RROON 19
ACOItil• CERTIFICATE
PRODUCER --- "
Willis Corroon Corporation of Maryland
10 North Park Drive
Hunt Valley MD 21030
(410) 527-1200
Contact : Kimberly S. Suarez—Murias
F.
30242
INSURED
Western Mobile Inc. and its subsidiaries
Mobile Premix
1400 W. 64th Avenue
Denver CO 80221
IN
ISSUE DATE (MM/DD/YY)
10—JUL-1995
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
COMPANY National Union Fire Insurance Co of
LETTER A
Pittsburgh PA
COMPANY
LETTER B
COMPANY
LETTER Ci
COMPANY
LETTER D
COMPANY
LETTER E
0 70
0
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORT POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPETO 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
LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
DATE (MWDD/YY) DATE (MM/DD/YY)
LIMITS
A
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE X OCCUR
X OWNER'S & CONTRACTOR'S PROT.
AUTOMOBILE LIABILITY
X
X
X
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
GARAGE LIABILITY
RMGL1212727
RMCA1351224
15-JUL-1995
15-JUL-1995
15-JUL-1996
15-JUL-1996
GENERAL AGGREGATE
PRODUCTS-COMP/OP AGG.
PERSONAL & ADV. INJURY
EACH OCCURRENCE
FIRE DAMAGE (Any one fire)
MED. EXPENSE (Any one pe
COMBINED SINGLE
LIMIT
BODILY INJURY
(Per person)
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
son
$ 2,000,000
$ 2,000 000_
1,000,000_
$ 1,000,000
$ 1,000,000
5,000
1,000,000
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
EACH OCCURRENCE
AGGREGATE
WORKER'S COMPENSATION
AND
EMPLOYERS' LIABILITY
OTHER
RMWC0171732
15-JUL-1995
15-JUL-1996
X
STATUTORY LIMITS
EACH ACCIDENT $ 1,000,000
DISEASE -POLICY LIMIT $1,000,000
DISEASE -EACH EMPLOYEE $ 1,000,000
DESCRIPTION OF OPERATIONSA.00ATIONSIVEHICLES/SPECIAL ITEMS
THIS CERTIFICATE MAY BE RELIED UPON ONLY IF THE DESCRIPTION OF
OPERATIONS ATTACHMENT REFERRED TO HEREIN IS ATTACHED HERETO.
CERTIFICATE HORDER.
Weld County
915 10th Street
Greeley CO 80632
A
i•.
90)
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NO
LIABILITY O .. K D UPY, ITS AGER REPRESENTATIVES.
ci
AUTHORIZED REPRES
SHALL IMPOSE NO OBLIGATION OR
(`ACO4 CLt1RPORA I
'1
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