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Home My WebLink About951823.tiffaf:11►itu. 'ti)aeeVC!R""'•'•"•• CEITIF ICATE OF IN Van Gilder Insurance Corp P.O. Box 911 Sterling, CO 80751 303-522-6260 yWNW Glen and Wayne Klee dba: K&K Roustabout Service PO Box 529 Sterling, t?UERAGkS 00 LTR A CO 80751 URAN DATSTMMIebIW)8/17/95 I HIS GENIIFICA IE IS ISSUED AS A MAT1bH OF INFORMA HON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY A United States Fidelity &:_Guar COMPA B COMPANY C COMPANY D ICY INDCATEED.NOTWITHSTANDINGANY EOUI EMENT, TERM ORCODITONOF ANYCONTR ACT ORO HERDOCLIMENT WITHREESPECTTOLWHCHTOHIISS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAMS. TYPEOF INSURANCE GENERAL LIABILITY X POLICY NUMBER POLICY EFFECTIVE DATE (MMIDDIYY) POLICY EXPIRATION DATE (MMIDDIYY) LIMITS COMI.ERCIAL GENERAL LIABILITY CLAIMS MACE X OCCUR OWNER'S S CONTRACTOR'S PROT AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS X SCHEDULED AUTOS X HIRED AUTOS NON -OWNED AUTOS GARAGE LIABILITY ANY AUTO 1MP30116209200 1MP30116209200 8/28/95 8/28/95 8/28/96 9/28/96 GENERAL ACd'OFOATE PRODLCTS•COMP/OP ADO PERSONAL L ADV INJURY EACH OCCURRENCE FIRE DAMAGE (Any one lire) $ 2000000 $ 2000000 S 1000000 1000000 50 .000 D EXP (Any one Person) $ 5 , 000 COMBINED SINGLE LIMIT $ BODILY INJURY (Per Person) t 1,000,000 BODILY INJURY (Per accident) t PROPERTY DAMAGE t EXCESS LIABILITY AUTO 0 . EA ACCIDENT $ OTHER THAN AUTO 0 EACH ACCIDENT $ AOOREOATE $ UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TEE PROPRIETOR/ PARTNERS/EXECUTIVE OFFICERS ARE: OTHER EACH OCCURRENCE t AOOREOATE S INCL EXCL STATUTORY LIMITS EACH ACCIDENT 1 DISEASE - POLICY LIMIT $ DISEASE -EACH EMPLOYEE $ Contractors Equip LIMIT ALL RISK DESCRIPTION OF OPENATIONSILOOATIONSIVEH ICLESISPECIAL ITEMS Orig: Cart Holder CC: Insured CC: USF&G/Van Gilder 8/28/95 8/28/96 562,500 TINCATE HOLD Weld County PO Box 758 Greeley, CO 80632 ATTN: Allen Miller AI 7ORD 25J8 (3198) ISa 111111:5- t f t f ANGELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES. ESENTATIVE 577461000 �A� a o 951823 Hello