HomeMy WebLinkAbout960871 AIDIIItII CERTIFICATE OF INSURANCE os/(osD96
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
211 First Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Eaton, CO 80615 COMPANIES AFFORDING COVERAGE
COMPANY
AGreat West Casualty
INSURED COMPANY
WILLIES GRAIN, INC. BColorado Compensation Authority
18302 HIGHWAY #392
GREELEY , CO 80631 COMPANY
C
COMPANY
D
I
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.LIMBS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO 'POLICY EFFECTIVE POLICY EXPIRATION
LTR TYPE OF INSURANCE POLICY NUMBER IDATE(MM/DD/YY) DATE(MM/DD/YY) I LIMITS
A GENERAL LIABILITY CLP31960F 06/01/96 06/01/97 GENERAL AGGREGATE $1, 000, 000
X COMMERCIAL GENERAL LIABILITY' PRODUCTS-COMP/OPAGG $ _
CLAIMS MADE XI OCCUR PERSONAL&ADV INJURY $1, 000,000
,OWNER'S&CONTRACTOR'S PROT i EACH OCCURRENCE $1, 000, 000
FIRE DAMAGE(Any one tire)$50 , 000
MED EXP(Any one person) $5, 000
A AUTOMOBILE LIABILITY CLP31960F 06/01/96 ' 06/01/97 COMBINED SINGLE LIMIT $1, 000 r QQO
X ANY AUTO
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per person) $
HIRED AUTOS BODILY INJURY
(Per accident)
$
NON-OWNED AUTOS
— 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 $
B WORKERS COMPENSATION AND 0999952 10/01/95 [ 10/01/96 X I,STATUTORYLIMITS
EMPLOYERS'LIABILITY EACH ACCIDENT $100 , 000
THE PROPRIETOR/
PARTNERS/EXECUTIVE -� INCL DISEASE-POLICY LIMIT $500, 000
OFFICERS ARE: X i EXCL DISEASE-EACH EMPLOYEE $100, 000
A OTHER CLP31960F 06/01/96 06/01/97 $100 , 000 Limit each
road Form/Cargo ' unit
$1, 000 Deductible
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS _a
COUNTY OF WELD IS LISTED AS AN ADDITIONAL INSURED.
CERTIFICATE HOLDER CANCELLATION , �k - -
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEEOT THE
COUNTY OF WELD EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO-MAIL
933 N 11TH AVENUE 1 O DAYS WRITTEN NOTICE TO THE CS FT.
Greeley, CO 80631 BUT FAILURE TOM ` CH NOTICE SHAL 960871 Y
OF ANY KIND UP-N HE COMPANY, 11_ ..___
AUTHORIZED RE , NTATIVE
• •
ACORD 25-s(3199)1 of 1 '' #N64213 �A' TION 1993
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