HomeMy WebLinkAbout961908.tiff ACIIRII® CERTIFICATE 'OF INSURANCE'' DATE(MM/DD/YY
' ' 10/02/96
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4821 Wheaton Drive 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
AThe Travelers Indemnity Company
INSURED
R. C. Heath Construction Co. COMPANY
BCIGNA
P. O. Drawer H - -
Fort Collins, CO 80522 COMPANY
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COMPANY
DI
COVERAGES ;,5 �y -
THIS IS TO CERTIFY THAT THE POLICIES PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WRM RESPECT-TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE.JRMS,
EXCLUSIONS AND CONDITIONS OF SUCH POUCIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION'
LTR DATE(MM/DD/YY) DATE(MIMIC D/YY) LIM
A _GENERAL LIABILITY 019ACM25680757CCA 09/30/96 09/30/97 GENERAL AGGREGATE $2, 000, 000
X COMMERCIAL GENERAL LIABILITY 'PRODUCTS-COMP/OP AGG $2, 0 0 0, 0 0 0
N CLAIMS MADE X OCCUR PERSONALBADV INJURY $1, 000, 000
WNER'SB CONTRACTOR'S PROT EACH OCCURRENCE $1, 000, 000
- FIRE DAMAGE(Any one fire)$10 0, 0 0 0
MED EXP(Any one person) 6, 000
A AUTOMOBILE LIABILITY 019FJ25680757CCA 09/30/96 09/30/97
X ANY AUTO COMBINED SINGLE LIMIT $1, 000, 000
ALL OWNED AUTOS
BODILY INJURY
__ SCHEDULED AUTOS (Par person) $
HIRED AUTOS -
BO ILY ONON-OWNED AUTOS . (Peraccident)INJURY
$
PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY:
- — -- -- EACH ACCIDENT $
I
AGGREGATE $
A EXCESS LIABILITY 019XS25680757CCA 09/30/96 09/30/97 EACH OCCURRENCE $2 , 000, 000
X l UMBRELLA FORM AGGREGATE $2, 000, 000
OTHER THAN UMBRELLA FORM $
B WORKERS COMPENSATION AND C4221694A 10/01/96 10/01/97 L STATUTORY LIMITS I
EMPLOYERS'LIABILITY EACH ACCIDENT 600, 000
THE PROPRIETOR/ INCL
PARTNERS/EXECUTIVE DISEASE-POLICY LIMIT $500 , 000
OFFICERS ARE: EXCL DISEASE-EACH EMPLOYEE 600, 000
A OTHER 019IB60921349 09/30/96 09/30/97 Limit $4 , 000, 000
Builders' Risk Deductible 1, 000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
CERTIFICATE HOLDER CANCELLATIONI
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Weld County EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
915 10th Street 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
n Greeley, CO 80631 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
a / i/r OF ANY KIND UPON THE COMPANY, IT GENTS OR REPRESENTATIVES.
/!) 1/9G AUTHORIZED REPRESE� A ,
ACORD25•S(3/9s)1 W 1 #M72218 SJK @VAACCCCICI // _/;
961908
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