HomeMy WebLinkAbout990263.tiff ACORD CERTIFICATE OF LIABILITY INSURANCEOP ID sr DATE(MM/DDNY)
CGRS--1 01/26/99
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
The Linden Co. of Northern Co. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
2900 South College Avenue-#35 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins CO 80525 COMPANIES AFFORDING COVERAGE _
Jeff Broyles COMPANY
Phone No. 970-229-9304 Fax No. 970-229-1398 A USF&G Insurance
INSURED COMPANY
B Business Insurance Company,-5
COMPANY
C G R S, Inc.
P. O. Box 1489 COMPANY
Ft. Collins CO 80522 p ;i i
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOQHEPOUQ.PERIObr
INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESR CT TO WHICH THICI
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TQ*.LL THE TORMS, -1 -
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. n.1
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS lJ'i
LTR DATE(MM/DD/YY) DATE(MM/CO/VY)
GENERAL LIABILITY GENERAL AGGREGATE $
COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $
CLAIMS MADE OCCUR PERSONAL Er ADV INJURY $
OWNERS&CONTRACTOR'S PROT EACH OCCURRENCE $
FIRE DAMAGE(Any one fire) $
MED EXP(Any one person) $
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT $ 000,000
A X ANY AUTO 1CP30031922800 03/16/98 03/16/99 1,
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS (Per person)
HIRED AUTOS
BODILY INJURY $
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE $
EXCESS UABILTTY EACH OCCURRENCE $
UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELLA FORM I$
WORKERS COMPENSATION AND WC STATU KITH TORY LIMBS
EMPLOYERS LIABILITY EL EACH ACCIDENT $ 100000
B THE PROPRIETOR/ INCL W992153966 02/01/99 02/01/00 EL DISEASE-POLICY LIMIT $ 500000
PARTNERSIEXECUTIVE
OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ 100000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
ALL OPERATIONS/ALL LOCATIONS. CERTIFICATE HOLDER IS NAMED AS ADDITIONAL
INSURED WITH RESPECTS TO AUTOMOBILE LIABILITY.
CERTIFICATE HOLDER CANCELLATION.
WELD-02 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
WELD COUNTY 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
c/o OFFICE OF PUBLIC WORKS BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
ATTN: DON SUMMERS
P.O. BOX 758 OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES.
GREELEY CO 80632 AUTHORIZED REPRESENTATIVE
i. �) 1 . .Jeff Broyles. . ' ,�! '" r-# v , /-. ,. .
" 990263 l/., t 31 �
/1^O D A I�`° • , AM DATE(MM1007YY)
/'"1V f- D' OF- LIABILITY, INSURANCE
1�+x�is a. ,.� i,k4•. t l .-< 1 103101 12121!98
vRODucE WILLIS CORROON CORPORATION (�^1 a .,!, •II TT�� ONLY THIS ANDCONFERS ISSUED AS H A MATTNR H INFORMAL I TE
NO RIGHTS UPON THE CERTIFICATE
OF LOS ANGELES HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
80GL N.BRAALE, DCA 91203#400 IBn9 Cn A! COMPANIES AFFORDING COVERAGE
GLENDALE, /`' �'- � j �: 00
COMPANY OLD REPUBLIC INSURANCE COMPANY
_ �! L FRK A
INSURED TELE-VUE SYSTEMS,INC. I U THE O," '� coMBPANYAMERICAN ALTERNATIVE INS.CO.
LLOYDS OF LONDON---
COMPANY
P.O.BOX 5630 C
COMPANY
DENVER,CO 80217-5630 D
,�. ,• Ir.�i�� a... .. .::.,�tS")•�,.rat;�:;;-.;!;:a.::;c:,i;;.;•:,:.,•.........................................................:�I�ta;"'a:i:•!?,r:
COV GA Y iii/ iiiiii33 I�iiii i chi �ii i�'ii I i'liiitiiii'h si`•'<?Ih'ii;i,l, ,t
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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION I LIMITS
LTR DATE(MM/CDJYY) DATE(MM/DD/YY)
A GENERAL LIABILITY MWZY54872 1/1/99 1/1/00 GENERAL AGGREGATE 5 1,000,000
x COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ 1,000,000
JCLAIMS MADE I x 1 OCCUR PERSONAL 8 ADV INJURY 5 1,000,000
OWNER'S 8 CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000
FIRE DAMAGE(Any one fire) $ 100,000
MED EXP(My one person) $
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT $
ANY AUTO
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per person) $
HIRED AUTOS BODILY 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 $
WL.JIAI U-
WORKERS COMPENSATION AND TORY LIMITS ER
EMPLOYERS'LIABILITY --I.---"" "------- --- ""--
EL EACH ACCIDENT $
THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT $
PARTNERS/EXECUTIVE -- -.
OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $
OTHER
DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLESISPECIAL ITEMS
RE:FRANCHISE AGREEMENT.CERTHOLDER IS NAMED AS ADDITIONAL INSURED ON THE GENERAL LIABILITY POLICY IF REQUIRED BY WRITTEN CONTRACT.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
COUNTY OF WELD 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
ATTN:COUNTY ATTORNEY BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
WELD COUNTY CLERK&RECORDER OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
915 10TH STREET AUTHORIZED REPRESENTATIVE
GREELEY,CO 80632
pp ,.. .�:•p,�:;.:;;,ra::'•r"i�a'I''""a ilu `1 Ill r+I:x:.;5`' �'a I?I�1 it i I I r I '.; : 111 I3r.t !I ct r AG D CORPORATIGN.1988
................ � ,.
•
_.,....,•, +-,--,!n,�- f-_..P„ ....,-ri-,.#aLdtR.'ttl•�t�.ii4�:,o,6!".-bhaA-! s....,;tli -Jzi,ty....��_, tt,1, .._ J, :..' �,h�=.a� .t
Hello