The URL can be used to link to this page

Browse Search

Home My WebLink About961344.tiff ACORQM CERTIFICATE OF LIABILITy INSURANCE DATE(AiiaioDlYY) PAGE; 1 OF 1 1t-JUL-tss6 PRODUCER - - - 36890 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Willis Corroon Corporation of Maryland ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 10 North Park Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Hunt Val ley MD 21030 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (410) 527-1200 COMPANIES AFFORDING COVERAGG COMPANY Indemnity Insurance Company of North America Kimberly S. Suarez-Murias A INSURED ' COMPANY Pacific Employers Insurance Compa� --� B ..-..., COMPANY Western Mobile Inc. and its subsidiaries - - - ' 1400 W. 64th Avenue C' -/) Denver CO 80221 COMPANY COVERAGES REPORTED AS OF;15-,lUL•1396 .. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOT W ITHSTANDING ANY REOUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHERDOCUMENT W ITHRESPECT TO WHICH HIGH 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' LIMITS LTR DATE(MMIDDIYY) DATE(MMIDD/YY) A GENERAL LIABILITY HD0G18969051 15-JUL-1996 15-JUL-1997 ,GENERAL AGGREGATE 6 2,000,000 COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG '..'$ 2,000,000 CLAIMS MADE I X OCCUR PERSONAL & ADV INJURY I 1,000,000 X OWNERS&CONTRACTORS PROT EACH OCCURRENCE 5 1,000,000 .FIRE DAMAGE (Any one fire) 6 1,000,000 MED EXP (Any one person) i 5,000 A AUTOMOBILE LIABILITY 1SAH07133364 15-JUL-1996 15-JUL-1997 COMBINED SINGLE LIMIT I 1,000,000 X ANY AUTO ALL OWNED AUTOS '.BODILY INJURY (Per person) 6 SCHEDULED AUTOS X HIRED AUTOS BODILY INJURY $ (Per accitlenp X NON-OWNED AUTOS PROPERTY DAMAGE $ GARAGE LIABILITY I i AUTO ONLY . EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY. EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ 1 UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA B WORKERS COMPENSATION AND CCSC42095230 15-JUL-1996 15-JUL-1997 X IWC STATU BOTH IEACH A ACCIDENT EMPLOYERS'LIABILITY EL EACH CIDE $ 1,000,000 THE PROPRIETOR/ INCL' EL DISEASE-POLICY LIMIT $ 1,000,000 PARTNERS/EXECUTIVE OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ 1,000,000 OTHER DESCRIPTION OF OPERATIONSLOCATIONSIVEHICLES/SPECIAL ITEMS III Project : Weld County Road 8 Weld County , Colorado is hereby named as an Additional Insured CERTIFICATE HOLDER 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, Weld County Commissioners BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 915 10th Street OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. Greeley CO 80632 AUTHORIZED REPRESENTA E ioatel- CA. ACotnD 25.5 f 1195) WESSTOZ sh p7 �2 M0 961344 ACORD,M CERTIFICATE OF LIABILITY INSURANCE DATE(MM/bblYY) PRODUCER ...: PAGE 1 OF i;.;. 11-JUL-1996 36890 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Willis Corroon Corporation of Maryland 10 North Park Drive ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Hunt Valley MD 21030 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR (410) 527-1200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY Indemnity Insurance Company of North America Kimberly S. Suarez-Murias _ A INSURED COMPANY Pacific Employers Insurance Company ' .. -) B Western Mobile Inc. and its subsidiaries COMPANY _. 1400 W. 64th Avenue C --1 4 -., , Denver - CO 80221 COMPANY ) ID �, COtrElAikEs _ ; R THISIS TO CERTIFY THAT THEPOLICIES OFINSURANCELISTEDBELOW HAVEBEENISSUEDtTRO TTH A 0F EINSURED NAMED ABOVEFOR THE PQLICYPERIOD t INDICATED,NOTWITHSTANDING ANY REOUIREMENT,TERM ORCONDITION OFANY CONTRACT OR OTHERDOCUMENT W ITHRESPECT TOW HIGH 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' LTYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION — - — DATE/MMIDD/TY) I DATE(MM/DD!YV) LIMITS A I GENERAL LIABILITY IHD0G18969051 15-JUL-1996 15-JUL-1997 GENERAL AGGREGATE ? 2,000,000 X I COMMERCIAL GENERAL LIABILITY I I� I PRODUCTS-COMP/OP AGG 1 CLAIMS MADE LX I OCCUR H_ 2,000.000 PERSONAL 8 ADV INJURY 15000,000 OWNERS &CONTRACTORS PROT 1,000,000 I-- _� EACH OCCURRENCE `S 1,000,000 I I FIRE DAMAGE (My one lire)f.$ 1,000,000 A LAUTOMOBLE LIABILITY I SAH07133364 MED EXP (Any one person) i$ 5,000 I y � 15-JUL-1996 I�I ANY AUTO 15-JUL-1997 COMBINED SINGLE LIMIT q 1,000,000 ALL OWNED AUTOS I_ SCHEDULED AUTOS BODILY INJURY )Li HIRED AUTOS (Per person) q NON-OWNED AUTOS (BODILY INJURY $ 1 I(Per accident) (PROPERTY DAMAGE GARAGE LIABILITY ANY AUTO AUTO ONLY . EA ACCIDENT $ OTHER THAN AUTO ONLY: I, EACH ACCIDENT f$_ fEXCESS LIABILITY AGGREGATE $ L_ UMBRELLA FORM EACH OCCURRENCE $ AGGREG ATE GATE EH THAN I UMBRELLA M3 ELLA FOR $ B WORKERS COMPENSATION AND iCCSC42095230 $ EMPLOYERSLIABILITY ' 15-JUL R -1996 15-JUL-1997 X�OnTI rsi I„gq _ THE PROPRIETOR/ EL EACH ACCIDENT PARTNERS/EXECUTIVE INCL $ 1,000,000 OFFICERS ARE: IEL DISEASE-POLICY LIMIT $ 1,000,000 EXCL OTHER IEL DISEASE-EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/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 MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Weld County Comm i Ss i Oner3 BUT FAILURE TO MAL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 915 10th Street OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. Greeley CO 80631 AUTHORIZED REPRESENTA E ACORp 20•S(119$) $ESST0Z AC CORFORATION 1989' ACOR TTM CERTIFICATE I INSURANCE DATE(NNIDDIVY) PRODUCER AA Cfm 1 1? 11-JUL-1996 36887 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Willis Corroon Corporation of Maryland 10 North Park Drive ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Hunt Val ley MD 21030 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR (410) 527-1200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY Indemnity Insurance Company of North,-America Kimberly S. Suarez-Murias A INSURED —._—_ ___ __ _— __- -___ _. ._ — _ _.__. -. COMPANY Pacific Employers Insurance-Company Biii Western Mobile Inc. and its subsidiaries COMPANY --1 i 1400 W. 64th Avenue C II rn Denver CO 80221 I COMPANY • D COVE CAGES REPORTED AS OF 18-.8A-1998 s • -*. THISISTOCERTIFY THAT THEPOLICIES OF INSURANCELISTEDBELOW HAVEBEENISSUED TO THEINSURED NAMED ABOVEFORTHEPPQQLICYPERIOD INDICATED NOTWITHSTANDING ANY REOUIREMEN7 TERMOR CONDITIONOFANYCONTRACT OR O7HERDOCUMENT WITHRESPECT T15 WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.co I - I ___..L TYPE OF INSURANCE POLICY EFFECTIVEPOLICY EXPIRATION LTRi POLICY NUMBER nen e,mymMvv) n.TR - LIMITS �nnryvr A I GENERAL LIABILITY HD0G1B969051 II 15-JUL-1996 15-JUL-1997 GENERAL AGGREGATE I$ 2,000,000 X I COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGO $ 000,000 i I CLAIMS MADE X OCCUR1 PERSONAL & ADV INJURY f 1,000,000 OWNER &CONTPACTOP PROT X u _ EACH OCCURRENCEI 1,000,000 I I -) - -- - `RE DAMAGE (Any one fire) I 1,000,000 MED EXP (Any one person)t 5,000 A AUTOMOBILE LIABILITY 1SAH07133364 J 15-JUL-1996 15-JUL-1997 LX._J ANY AUTO COMBINED SINGLE LIMIT i 1,000,000 I ALL OWNED AUTOS I- — _ SCHEDULED AUTOS IBODILY INJURY (Per person) $ X I HIRED AUTOS X- BODILY INJURY9 NON-OWNED AUTOS [(_Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY I AUTO ONLY • EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: IF EACH ACCIDENT $ EXCESS LIABILITY ,I AGGREGATE $ 111 LEACH OCCURRENCE $ UMBRELLA FORM IIAGGREGATE I � $ GTn-ER TriAly JlddhcLL:. runt' $ B WORKERS COMPENSATION AND CCSC42095230 15-JUL-1996 15-JUL- IS STANI OTH'EMPLOYERS'LIABILITY 1997 X iACH ACCIDENT ER _ THE PROPRIETOR/ EL EACH ACCIDENT $ 1,000,000 PARTNERS/EXECUTIVE - '- - - - - INCL EL DISEASE-POLICY LIMIT $ OFFICERS ARE: 1,000,000 EXCLI EL DISEASE-EA EMPLOYEE I$ 1,000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESISPECIAL ITEMS CERTIFICATE HOLDER 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, Board of Weld County Commissioners BUT FAILURE TO MAfL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 915 10th Street OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. Greeley CO 80632 AUTHORIZED REPRESENTAT E ACORO 25•$(1/95) 5s 1WES♦4T% !�� IIR0 CORPOHATION 1988 ACORD CERTIFICATE OF'CIABIUTY INSURANCE PA_E 1 OF 2 ', 11 -1996' PRODUCER 36890 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Willis Corroon Corporation of Maryland ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 10 North Park Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Hunt Val ley MD 21030 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (410) 527-1200 COMPANIES AFFORDING COVERAGE COMPANY Indemnity Insurance Company of North Amer ica ,...»....,_-- Kimberly S. Suarez-Murias A ------- — ---- INSURED COMPANY Pacific Employers Insurance Company B COMPANY Western Mobile Inc. and its subsidiaries C 1400 W. 64th Avenue - Denver CO 80221 COMPANY - I t D 1O COVERAGES REPORTED AS OE I IS-AS,-190t)k !`$ THIS ISTOCERTIFY THAT THEPOLICIES OF INSURANCE LISTEDBELOW HAVEBEEN ISSUED TOTHEINSURED NAMED ABOVE FT}R THE POLICYPERIOD INDICATED,NOTWITHSTANDING ANY REOUIREMENT,TERM OR CONDITIONOF ANY CONTRACT OR OTHERDOCUMENT W ITHRESPECTTO W HICHTHIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO,9LL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. -i CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS- LTR DATE(MMIDDIVY) DATE(MMIDDIYY) .3 A GENERAL LIABILITY HD0618969051 15-JUL-1996 15-JUL-1997 GENERAL AGGREGATE $ 2,000,000 X COMMERCIAL GENERAL LIABILITY , PRODUCTS-COMP/OP AGG $ 2,000,000 CLAIMS MADE X J OCCUR PERSONAL & ADV INJURY $ 1,000,000 X OWNERS &CONTRACTORS PROT EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one lire) $ 1,000,000 I MED EXP (Any one person) $ 5,000 I A AUTOMOBILE LIABILITY 1SAH07133364 15-JUL-1996 15-JUL-1997 COMBINED SINGLE LIMIT $ 1,000,000 X ANY AUTO Imo__.ii ALL OWNED AUTOS BODILY INJURY $ Ii(Per person) SCHEDULED AUTOS X HIRED AUTOS BODILY INJURY $ (Per acciden)) X , NON-OWNED AUTOS _ —PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY EACH ACCIDENT $ '- AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ I - UMBRELLA FORM AGGREGATE $ — 11 OTHER THAN UMBRELLA FORM _ B WORKERS COMPENSATION AND ICCSC42095230 15-JUL-1996 15-JUL-1997 �' X WC STATU 0Th TORY LIMI1� ES -- EMPLOYERS'LIABILITY EL EACH ACCIDENT $ 1,000,000 THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT $ 1,000,000 PARTNERS/EXECUTIVE - - OFFICERS ARE- EXCL EL DISEASE-EA EMPLOYEE 1$ 1,000,000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESISPECIAL ITEMS SEE ATTACHED CERTIFICATE HOLDER 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. Weld County BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 915 10th Street OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. Greeley CO 80632 AUTHORIZEDREPRESENTA E ACORD 2SI$(1,05) WESST0I AC OCORPORATION 1988 ISSUE DATE(MM/DD/YY) cORRLooN CERTIFICATE Of IN�A1\C PAGE OF $ I 11-JUL-1996 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. INSURED 36890 PRODUCER Willis Corroon Corporation of Maryland 10 North Park Drive Hunt Valley MD 21030 Western Mobile Inc. and its subsidiaries (410) 527-1200 1400 W. 64th Avenue Denver CO 80221 Kimberly S. Suarez-Murias 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFFECTIVE POLICY EXPIRATION TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YV) LIMITS DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS General Liability - The Certificate Holder is an Additional Insured solely as respects work performed by or for the Named Insured in connection with 1992 Chip and Seal Project , provided , however , that a written contract requiring that the Certificate Holder be an Additional Insured exists . CERTIFICATE HOLDER 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, Weld County BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 915 10th Street OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. Greeley CO 80632 AUTHORIZED REPRESENT VE ,( y��('C/JC/,,lam WILLIE CORROON:25WC1 (91955) WESSTUZ F`� wILL16 C RROON 1995 Hello