HomeMy WebLinkAbout952194.tiffAICIIRII®
CERTIFICATE
OF INSURANCE
iojoz/9s
PRODUCER
Flood & Peterson Insurance Inc
4821 Wheaton Drive
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.
P O Box 270370
COMPANIES AFFORDING COVERAGE
Fort Collins, CO 80527
COMPANY
AAetna Casualty & Surety Company
INSURED
R. C. Heath Construction Co.
COMPANY
BCIGNA ,,
-A
P. O. Drawer H
Fort Collins, CO 80522
COMPANY a
"1
t
COMPANY T 0 ' r'
D 'IT r i _ 0
m uT
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED Ik/IGVE FOR?fiE POL -PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WON RESPROT TOI� H THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL; TIiEeTERMS,
_ EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. N-"> '
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE(MM/DD/YY)
POLICY EXPIRATION
DATE(MM/OD/YY)
V
LIMITS
A
GENERAL
X
LIABILITY
COMMERCIAL GENERAL LIABILITY
019ACM24343821
09/30/95
09/30/96
GENERAL AGGREGATE
$2,000,000
PRODUCTS-COMP/OP AGO
$2,000,000
CLAIMS MADE
X
OCCUR
PERSONAL B ADV INJURY
$1,000 000
OWNERS A CONTRACTORS PROTI
EACH OCCURRENCE
$1,000,000
FIRE DAMAGE (Any One /Ire)
$ 100,000
MED EXP(Any one person)
$ 5, 000
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
019FJ25037476
09/30/95
09/30/96
COMBINED SINGLE LIMIT
$1,000,000
BODILY INJURY
(Per person)
$
BODILYINJURY
(Per accident)
$
PROPERTY DAMAGE
$
GARAGE
LIABILITY
ANY AUTO
AUTO ONLY -EA ACCIDENT
$
OTHER THAN AUTO ONLY
EACH ACCIDENT
$
AGGREGATE
$
A
EXCESS
X
LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
019XS25037476
09/30/95
09/30/96
EACH OCCURRENCE
$1,000,000
AGGREGATE
$1,000,000
$
B
WORKERSCOMPENSATION
EMPLOYERS' LIABILITY
THE PROPRIETOR/
PARTNERS/EXECUTIVE
OFFICERS ARE:
AND
INCL
EXCL
C41295983
10/01/95
10/01/96
STATUTORY LIMITS
$500,000
EACH ACCIDENT
DISEASE -POLICY LIMIT
$500,000
DISEASE -EACH EMPLOYEE
$500, 000
A
OTHER Leased
Equipment
019IZ25058734
09/30/95
09/30/96
$100,000 Limit
$ 500 Deductible
Special Form
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
CERTIFICATE HOLDER
Weld County
915 10th Street
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
"A (1 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
I(br`1" rl I� reeley, CO 80631
'��nJ, N
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
Ie/061 II4 `,
ACORD2s•S(3.$9s)1 Gt1 #M51900
AUTHORIZED REPRESENT? cy I)
TAP 00 ss2is4 1993
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