HomeMy WebLinkAbout972128.tiffa1C11R11® CERTIFICATE
OF INSURANCE
DATE
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 O Box 270370
COMPANIES AFFORDING COVERAGE
Fort Collins, CO 80527
COMPANY
ACNA Insurance Company
INSURED
Fisher Mechanical Contractors,
COMPANY
BCIGNA
Inc'
COMPANY . -
C r,
2305 W. 9th Street
Greeley, CO 80631
COMPANY
D
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDAAOVE FORD* POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO want THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT ALL ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR
TYPE OF INSURANCE
POLICY NUMBER
PO LILY EFFECTIVE
DATE(MM/DD/YY)
OLICY EXPIRATION
DATE(MM/D ENVY)
LIMITS
A
GENERAL
X
LIABILITY
COMMERCIAL GENERAL LIABILITY
B115682950
08/25/97
08/25/98
GENERAL AGGREGATE
$1, 00000
PRODUCTS-COMP/OPAGG
$1, 000, 000
PERSONAL SADV INJURY
$500,000
CLAIMS MADE
XI OCCUR
EACH OCCURRENCE
$500, 000
O
OWNER'S S CONTRACTORS PRO T
FIRE DAMAGE (Any one (Ire)
$50,000
MED EXP (Any one person)
5,000
A
AUTOMOBILE
X1
r --
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
B115682964
08/25/97
08/25/98
COMBINED SINGLE LIMIT
$500,000
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
$
GARAGE
LIABILITY
ANY AUTO
AUTO ONLY -EA ACCIDENT
$
OTHER THAN AUTO ONLY
EACH ACCIDENT
$
AGGREGATE
$
A
EXCESS
X
LIABILITY
UMBRELLA FORM
OTHER THAN VM B RE LLP. FORM
B115682978
08/25/97
i
08/25/98
EACH OCCURRENCE $1,000,000
AGGREGATE
$1, 0000
v
B
WORKERS COMPENSATION
EMPLOYERS' LIABILITY
THE PROPRIETOR/
PARTNERS/EXECUTIVE
OFFICERS ARE:
AND
INCL
EXCL
C42299388
08/25/97
08/25/98
J STATUTORY LIMITS
EACH ACCIDENT
$100,000
DISEASE -POLICY LIMIT
$500,000
DISEASE -EACH EMPLOYEE .$100, O
OTHER
DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLES/SPECIAL ITEMS
CERTIFICATE HOLDER
Weld County, Colorado
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
C/O Board of County
Commissioners P.O. Box 758
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE C•MPANY, ITS AGENTS OR REPRESENTATIVES
Greeley, CO 80632
ACORD25•S(a/9)1 D$1 ' #M91847
AUTHORIZED REPRESENTATI E 0.) e
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