HomeMy WebLinkAbout961279.tiff : AC11I:11® CERTIFICATE OF INSURANCE DAIErD96)
PRODUCER ' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
MACHANN INSURANCE AGENCY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
11160 No• Huron, Suite 36 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Northglenn, CO 80234 COMPANIES AFFORDING COVERAGE
COMPANY
A BITUMINOUS
INSURED COMPANY
B U. S. F. & G•
RICHARDSON CONTRACTING, INC• COMPANY
P• 0• Box 866 C
Greeley, CO 80631 COMPANY
`1 '
D
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TQ ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY)
GENERAL LIABILITY GENERAL AGGREGATE $ 2,000,000•
XI COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OPAGG $ 2,000,000.
A CLAIMS MADE I X OCCUR, CO14954-180 7/15/96 7/15/97 PERSONAL&ADVINJURY $ 1,000,000•
OWNER'S&CONT PROT EACH OCCURRENCE $ 1,000,000•
FIRE DAMAGE(Any one fire) $ 50,000.
MED EXP(Any one person) $ 5,000•
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000.
X ANY AUTO 1AT30002238200 7/15/96 7/15/97
B ALL OWNED AUTOS BODILY I
JURY $
SCHEDULED AUTOS
)
HIRED AUTOS BODILY INJURY $
(Per accident)
INON-OWNED AUTOS '.
PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT $
' -- - AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $
• UMBRELLA FORM AGGREGATE $
$
OTHER THAN UMBRELLA FORM
-WORKERS COMPENSATION AND _ STATUTORY LIMITS __-
EMPLOYERS'LIABILITY EACH ACCIDENT $
1, THE PROPRIETOR/ INCL DISEASE-POLICY LIMIT $
I PARTNERS/EXECUTIVE DISEASE-EACH EMPLOYEE $ _
OFFICERS ARE: EXCL_ .. _ _- .. . . . .... ...... .
OTHER
1 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
I
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
I WELD COUNTY EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
1 P• 0• BOX 758 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Greeley, CO 80632 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPA , ITS AG
J1' �EIINTS OR REPRESENTATIVES.
C AUTHORIZED REPRESENTATIVE N Y 1 i
O
r ATTN: EDNA MATH
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RD 25-S(3/93) ..._ 961279
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