HomeMy WebLinkAbout972225.tiffAICIIItWI® CERTIFICATE
OF
INSURANCE
TE(O1/97�
10
PRODUCER
Flood & Peterson Insurance Inc
4821 Wheaton Drive
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.
P 0 Box 270370
COMPANIES AFFORDING COVERAGE
Fort Collins, CO 80527
COMPANY
ATravelers Insurance
INSURED
R. C. Heath Construction Co.
COMPANY
BCIGNA
P. 0. Drawer H
Fort Collins, CO 80522
-
COMPANY
C
24
I
COMPANY
D
COVERAGES
THIS IS 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
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE(MM/DD/YY)
POLICY EXPIRATION
DATE(MM/DD/YY)
LIMITS
A
GENERAL
X
LIABILITY
COMMERCIAL GENERAL LIABILITY
DTHCO298N6651
09/30/97
09/30/98
GENERAL AGGREGATE
$2,000,000
PRODUCTS-COMP/OPAGG
$2, 000, 000
CLAIMS MADE
XI OCCUR
PERSONAL & ADV INJURY
$1, 000, 000
O
OWNER'S & CONTRACTOR'S PROT
EACH OCCURRENCE
$1, 000, 000
FIRE DAMAGE (Any one fire)
$100,000
MED EXP (Any one person)
s5,000
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
DTJ810298N6651
09/30/97
i
09/30/98
COMBINED SINGLE LIMIT
$1, OQQ, 0Q0
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$ -
PROPERTY DAMAGE
$
I GARAGE LIABILITY
_ ANY AUTO
I
AUTO ONLY -EA ACCIDENT
$
OTHER THAN AUTO ONLY:
EACH ACCIDENT
$
AGGREGATE
$
A
EXCESS
X
LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
DTSFJCUP298N6651
09/30/97
09/30/98
EACH OCCURRENCE
6,000,000
AGGREGATE
$5,000,000
$
B
I
WORKERS COMPENSATION
EMPLOYERS' LIABILITY
THE PROPRIETOR/
PARTNERS/EXECUTIVE
OFFICERS ARE:
AND
INCL
EXCL
C42476043
10/01/97
10/01/98
.c STATUTORY LIMITS
$500,000
EACH ACCIDENT
DISEASEPOLICYLIMIT
600,000
DISEASE -EACH EMPLOYEE
$5 00,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
CERTIFICATE HOLDER
Weld County
915 10th Street
Greeley, CO 80631
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 NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPAN ITS AGENTS OR REPRESENTATIVES.
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ACORD2S3)110f1 1 #M93765
AUTHORIZED REPRESENTATIVE
, 4/ 114
SJK 01 _._-_---
972225
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