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CERTIFICATE OF INSURANCE ISSUE DATE IMM/DD/YY) 1
3-01-96
POOL ADMINISTRATOR This certificate is issued as a matter of information only and
Rollins Hudig Hall of Colorado, Inc. confers no rights upon the certificate holder. This certificate
4100 E. Mississippi does not amend, extend or alter the coverage afforded by the
Denver, CO 80222 policies below.
INSURED North Weld County Water INSUROR
Attn : Lyle Nelson Colorado Special Districts Property and Liability Pool
PO BOx x 56
car t� CD 804A6 rs
COVERAGES
This is to certify that the policies of insurance listed below have been issued to the insured named &love forfhe policy
period indicated, notwithstanding any requirement, term or condition of any contract or other docun t`�vithlrespeigt-o
which this certificate may be issued or may pertain. The insurance afforded by the policies describetgein s subjog
to all the terms, exclusions and conditions of such policies. :
POLICY POUCY i 9 -mot
TYPE OF INSURANCE POLICY NUMBER EFFECTIVE EXPIRATION LIMITS u�
DATE DATE N
GENERAL LIABILITY
Commercial Form 82-0009—PKG 2-25-96 2-25-97 $150,000/Person and 8600,000/
rp Premises/Operations Occurrence for claims subject to the
Products/Completed Ops. Colorado Governmental Immunity
IS Personal Injury Act. For claims not subject to the
Colorado Governmental Immunity
Act, limits are $1,000,000
Combined Single Limit per
Occurrence; $2,000,000 General
Aggregate; $1,000,000 Products/
Completed Operations Aggregate.
PROPERTY
❑ Building
❑ Personal Property
❑ EDP
❑ Equipment
❑ Other
$150,000/Person and $600,000/
AUTOMOBILE LIABILITY Occurrence for claims subject to the
Any Auto 82-0009—PKG 2-25-96 2-25-97 Colorado Governmental Immunity
❑ Hired Autos Act. For claims not subject to the
❑ Non-Owned Autos Colorado Governmental Immunity
❑ Garage Liability Act, limits are $1,000,000
Combined Single Limit.
AUTO PHYSICAL DAMAGE
❑ Comprehensive/Deduct.
❑ Collision/Deduct.
DESCRIPTION:
CERTIFICATE HOLDER CANCELLATION
Should any of the above described policies be cancelled
Weld County befoc .the expiration date thereof, the Pool will endeavor to
PO Box 758 mail days written notice to the certificate holder named
Greeley , CO 80632 to theTeft, but failure to mail such notice shall impose no
�n f� obligation or liability of any kind upor
r,V1 or rep s nt ives. 960400
so
OS/Otriegi �.
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