HomeMy WebLinkAbout962412.tiff CERTIFICATE OF INSURANCE 06/20/6
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
J. W. Terrill, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
701 Emerson Road, 5th Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW.
P.O. Box 419092 COMPANIES AFFORDING COVERAGE
St. Louis, MO 63141-9092 COMPANY
Attn: Elaine Knobler 314/991-1730 ATwin City Fire Ins. Co. (Hartford)
INSURED COMPANY
Galaxy Cablevision BHartford Fire Insurance Co.
Galaxy Telecom, L. P. d/b/a COMPANY
1220 North Main Street CHartford Underwriters
Sikeston, MO 63801
COMPANY
DHartford Casualty Insurance Co.
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 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATIONI LIMITS
LTR DATE(MM/DD/YY) DATE(MM/DD/Y1)
A GENERAL LIABILITY 84UUNPJ6774 06/23/96 06/23/97 GENERAL AGGREGATE s2, 000, 000
X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OPAGG$2 , 000, 000
CLAIMS MADE X OCCUR PERSONAL$A DV INJURY $1, 000, 000
OWNERS&CONTRACTORS PROT EACH OCCURRENCE $1, 000, 000
FIRE DAMAGE(Any one f Ire)$ 300, 000
MED EXP(Any one person) $ 10, 000
B AUTOMOBILE LIABILITY 84UENPJ6952 06/23/96 06/23/97 COMBINED SINGLE LIMIT $1 000, 000
,C X ANY AUTO 84UENPJ7336 (TX) 06/23/96 06/23/97
ALL OWNED AUTOS
BODILYINJURY $
SCHEDULED AUTOS (Per person)X HIRED AUTOS BODILY INJURY
X NON-OWNED AUTOS (Per accident) $
PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE $
D EXCESS LIABILITY 84RHUPJ7550 06/23/96 06/23/97 EACH OCCURRENCE $10, 000, 000
X UMBRELLA FORM AGGREGATE $10, 000, 000
OTHER THAN UMBRELLA FORM I $
A WORKERSCOMPENSATIONAND 84WBAW2292 06/23/96 06/23/97 STATUTORYLIMITS
EMPLOYERS'LIABILITY AL CO FL GA IA ID EACH ACCIDENT $500, 000
THE PROPRIETOR/ X INCL IL KS KY LA MO MS DISEASE-POLICY LIMIT $500, 000
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL NE SC SD TN TX DISEASE-EACH EMPLOYEE $500, 000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
Certificate holder, its officers, borads, commissions and employees are
additional insureds on the general liability as their interest may appear.
CER7ffICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE
County of Weld EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Attn: Office of County Attorney 39-DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
P.O. Box 1948 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
Greeley, CO 80632 OF ANY KIND UPON THE C Y AGENTS OR REPRESERTATI S.
AUTHORIZED REPRESENTATIVE /
ACORD25•S(3193)1 of 1 #M67604 962412 l 0` ACORD �9a9
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