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CERTIFICATE OF INSURANCE
This is to certify that insurance policies issued to C. D.,....MANLON, GERAIDojIANON--AND•.DAVID
...C.RQ.P.PE.R....DSA...MAN.I.ON....AND CR.OPP.ER.,....P... t0 ess) BOX_..7.1.8f....EAT..ON.,....CALO.RADO
the numbers and expiration dates of which are listed below, arc in force in this Company as of OCTOBER 2, 1964
(Date)
covering in accordance with the terms thereof at the following location C.OLO.RADO....AND...E.LS.EWHERE
POLICY
NUMBER
LIMITS OF LIABILITY
KIND OF
POLICY
EXPIRATION
DATE
Injury
Property Damage
pa Y
A —Workmen's
Compensation
_
Provided by Workmen's
Compensation Law
State of
Nil
B —Manufacturers or
Contractors Liability
Each person $
Each accident $
Each accident $
Aggregate $
C —Owners or Contractors
Protective Liability
Each person $
Each accident $.
Each accident $
Aggregate $
D —Owners, Landlords
and Tenants Liability
_
Each person $
Each accident $
Each accident $
E —Automobile
Liability
(1) Owned Vehicles
(2) Hired Vehicles
(3) Other Non -owned
Vehicles
Each person $
Each accident $-
Each accident $
Each person $
Each accident $
Each accident S
Each person $
Each accident $
Each accident $
F —Comprehensive
Liability
(1) Comprehensive
Automobile
(2) Comprehensive
General
(3) Comprehensive
(combined General
and Automobile)
Each person $.. .
Each accident $
Each accident $
Each person $
Each accident $
Aggregate $
Each accident $
Aggregate $
LC252278
8/10/67
Each person $...1.0.0..fo.00
Each accident $...3().(1..`..0.0.0
Aggregate $.3. Q.0.,..Q.0.Q
E
Each accident $ 54.0.0.0
Aggregate $10 0, 0 0 0
Each person $
Each accident $
Aggregate $
Each accident $
Aggregate $
* Property damage caused by blasting or explosion (other than explosion of machinery or pressure equipment) excluded.
* Property damage caused by collapse of or structural injury to buildings excluded.
* Property damage underground caused by mechanical equipment excluded.
This Certificate is issued at the request of:
Name COUNTY COMMISSIONERS.,... WELD CO11N•I.Y.., COLORADO
Address GREELEY, -COLORADO
to whom we will mail written notice of canoeI at ion orany changes affecting this Certificate.
NEW AMSTE M CASUALTY COMPANY
RSO,N, INC.
PE_«y
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Authorized Representative
640136
CERTIFICATE OF INSURANCE
ISSUED BY
STATE COMPENSATION INSURANCE FUND
660 STATE CAPITOL ANNEX
Denver, Colorado
Weld County Court House Contract
Weld County Commissioners
Weld County, Colorado
This is to certify that this Department has issued a Standard
Workmen's Compensation and Employers' Liability Policy as described
below covering the liability imposed upon subject employers by the
Workmen's Compensation Act of Colorado and the Colorado Occupational
Disease Disability Act; said policy being in good standing as of
this date.
Policy No. 30669/0
Policy Period: From
NAME OF INSURED
Address
NOVEMBER 1, 1963 NOVEMBER 1, 1964
NOVEMBER 1. 1964 To
NOVEMBER 1. 1965
C. D. MANION AND GERALD MAd1ON ET AL DBA
P O. BOXC71U,EEATONSTCOLORADOCO.
POLICY ENDORSEMENTS:
MONTHLY ADJUSTMENTS
In the event of any material change in, or termination of the
policy, the State Compensation Insurance Fund will make every effort
to notify the party to whom this Certificate is addressed of such
change or termination, but, it undertakes no responsibility by
reason of any failure so to do.
Dated OCTOBER 7, 1964
GWA/jp
9/6/60
BES:O
STATE COMPENSATION INSURANCE FUND
BY • _ _ .r, -(L _, ? --»=
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