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Home My WebLink About961536.tiff CTO11D0102TU018000ASSDO2 CLP31960F 0019 GFZ 1 01 ACOIt"e CERTIFICATE OF INSURANCE _ IISSSUE DATE(MMIDDIVV) CERTIFICATE(V'' {Y�. N !V■K [M'iFi.. £I 06/07/96 PRODUCER 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 FLOOD & PETERSON INSURANCE , INC . POLICIES BELOW. 211 FIRST STREET COMPANIES AFFORDING COVERAGE EATON, CO 80615 COMPANY A LETTER ri f;RFAT WFST f ASI1A. LtY COMPANY COMPANY B INSURED LETTER WILLIES GRAIN, INC . COMPANY LETTER t 18302 HIGHWAY 392 GREELEY, CO 80631 COMPANY D LETTER COMPANY E LETTER 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 AFFORDEDBY 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(MM/DD/VY) GENERAL LIABILITY GENERAL AGGREGATE S 12000 , 000 A X COMMERCIAL GENERAL LIABILITY CLP31960F 06/01/96 06/01/97 PRODUCTS-COMP/OP AGG. E !� I CLAIMS MADE X OCCUR. PERSONAL&ADV.INJURY S 11000 , 000 X OWNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE $ 1 , 0009000 FIRE DAMAGE(Any one firs) $ 50 , 000 MED.EXPENSE(Any one person) Si 51000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S A X ANY AUTO CLP31960F 06/01/96 06/01/97 1 , 000 , 000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON OWNED AUTOS (Per accident) GARAGE LIABILITY PROPERTY DAMAGE S EXCESS LIABILITY I EACH OCCURRENCE S UMBRELLA FORM AGGREGATE S OTHER THAN UMBRELLA FORM STATUTORY LIMITS WORKER'S COMPENSATION EACH ACCIDENT $ AND DISEASE POLICYLIMIT $ EMPLOYERS LIABILITY - DISEASE EACH EMPLOYEE S OTHER A CARGO LIABILITY CLP31960F 06/01/96 06/01/97 PER AUTO S 100 , 000 BROAD FORM DEDUCTIBLE $ 1 , 000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS CERTIFICATE!HOLDER ! CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO COUNTY OF WELD MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE 933 N 11TH AVENUE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR GREELEY, CO 80631 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. ≥'J AUTHORIZ D REPRESENTATIVE ACORD 25.5(119tH OACORD CORPORATION 1990 Flood and Peterson Insuurance, Inc. August 9, 1996 CLL.:, :0 T1'._ COUNTY OF WELD 933 N 11TH AVENUE GREELEY, CO 80631 Re: WILLIES GRAIN, INC Great West Casualty Policy #CLP31960F Dear Sir: Enclosed you will find an Additional Insured Endorsement issued in your favor on behalf of the above captioned insured. If you should have any questions, please feel free to give our office a call. Sincerely, JY dy Gustafson C/ Customer Service Representative /jmg Enclosure gi(119(O 211 First Street• Eaton,Colorado 80615•(970)454-3381 •Fax(970)454-3252 961536 "Sernng People Since 1939" POLICY NUMBER: CLP31960F THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL AUTO COVERAGE PART This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured Endorsement effective WILLIES GRAIN , INC . JUNE 1 1996 Countersigned b GREAT WEST CASUALTY COMPANY ��- uthorized R resentative) SCHEDULE Policy Expiration Date JUNE 1 1997 Name of Additional Insured COUNTY OF WELD 933 N 11TH AVENUE GREELEY , CO 80631 Described Auto APPLIES TO ALL TRUCKS, TRACTORS , & TRAILERS OWNED, LEASED, HIRED, RENTED, OR BORROWED WHICH ARE USED BY THE NAMED INSURED LIABILITY COVERAGE WHO IS AN INSURED is Coverage provided by this endorsement applies to changed to include as an Insured the person or "Autos" described in the SCHEDULE. organization shown in the SCHEDULE only if they The coverage provided by this endorsement ends are liable for the conduct of an Insured shown in the when the Additional Insured is not liable for your WHO IS AN INSURED provisions and only to the conduct or the Policy Expiration Date, whichever extent of that liability. occurs first. CA 49 01 03 92 Includes copyrighted material of Insurance Services Office, Inc.,with its permission Page 1 of 1 Copyright, Insurance Services Office, Inc., 1986 Hello