HomeMy WebLinkAbout952676.tiffCertificate of Insurance
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFOR,.... ,ON ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFIG, _ _ HOLDER. THIS CERTIFICATE IS NOT AN INSURANCE
POLICY AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW.
This is to Certify that
JONES INTERCABLE INC, ETAL
(SEE ATTACHED NAMED INSURED WORDING)
9697 E MINERAL AVENUE
ENGLEWOOD CO 80112
Name and
address of
Insured
LIBERTY
MUTUAL
is, at the issue date of this certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the
listed policy(ies) is subject to all their terms, exclusions and conditions and is not altered by any requirement, term or condition of
any contract or other document with respect to which this certificate may be issued.
CERTIFICATE EXP. DATE
• Q CONTINUOUS
Q EXTENDED
El POLICY TERM
TYPE OF POLICY
POLICY NUMBER
LIMIT OF LIABILITY
WORKERS
COMPENSATION
04-01-98
04-01-98
04-01-98
WA1-69D-004082-135
WA1-69D-004082-165
WC1-691-004082-015
Coverage Afforded Under WC
Law of the Following States:
CA CO FL GA IL IN MD MI
MO NE NM NY SC TX VA
MINNESOTA
'AZ HI NJ OR PA WI KS
EMPLOYERS LIABILITY
Bodily Injury By Accident Each
500,000 Accident
Bodily Injury By Disease Policy
500,000 Limit
Bodily Injury By Disease Each
500,000 Person
GENERAL LIABILITY
t l CLAIMS MADE
RETRO DATE
X❑ OCCURRENCE
04-01-98
TB1-691-004082-035
General Aggregate -Other than Prod/Completed Operations
3,000,000
Products/Completed Operations Aggregate
3,000,000
Bodily Injury and Property Damage Liability Per
1,000,000 Occurrence
Personal and Advertising Injury
1,000,000
Other:
Includes: Explosion & Collapse Hazard Underground
Products Completed Operations, Premises & Operations,
Independent Contractors/Contractors Protective,
Hazard Personal Injury, Contractual Liability.
1,000,000 Each Accident -Single Limit-B.I. and P.D
Combined
Per Person/
Organization
AUTOMOBILE
LIABILITY
O OWNED
X❑ NON -OWNED
X❑ HIRED
04-01-98
AS2-691-004082-045
Each Person
Each Accident or Occurrence
Each Accident or Occurrence
OTHER: *All States Coverage Excludes Maine. WA Policy -Includes Deductible
Endorsement with $350,000 Deductible Per Occurrence/Claim (Disease) with an
Aggregate Deductible All Bodily Injury of $3,200,000 With The Provision That
Liberty Mutual May/Will Advance Payment of The Deductible Amount.
ADDITIONAL COMMENTS
It is hereby agreed that Weld County is named additional insured as their interest may appear.
Re: Jones Cable Income Fund I-B/C Venture -Broomfield, Colorado
`IF THE CERTIFICATE EXPIRATION DATE IS CONTINUOUS OR EXTENDED TERM, YOU WILL BE NOTIFIED IF COVERAGE IS TERMINATED OR REDUCED
BEFORE THE CERTIFICATE EXPIRATION DATE. HOWEVER, YOU WILL NOT BE NOTIFIED ANNUALLY OF THE CONTINUATION OF COVERAGE.
SPECIAL NOTICE - OHIO: ANY PERSON WHO, WITH INTENT TO DEFRAUD OR KNOWING THAT HE IS FACILITATING A FRAUD AGAINST AN INSURER,
SUBMITS AN APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS GUILTY OF INSURANCE FRAUD.
NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS Liberty Mutual
ENTERED BELOW.) BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT Insurance Group
CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL
UNTIL AT LEAST 0 DAYS NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO:
CERTIFICATE
HOLDER
Asst County Attorney
Weld County
PO Box 1948
Greeley CO 80632
Or-C�G�
AUTHORIZED REPRESENTATIVE
4-1-95 ENGLEWOOD
DATE ISSUED
952676
This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such Insurance as is afforded by Those Companies BC 772L
Hello