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Address Info: 1150 O Street, P.O. Box 758, Greeley, CO 80632 | Phone:
(970) 400-4225
| Fax: (970) 336-7233 | Email:
egesick@weld.gov
| Official: Esther Gesick -
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970723.tiff
ACORD Certificate r of Insurance Issue Date: March 31, 1997 Producer: u t l Willis Corroon Corporation of Minnesota 200 South Sixth Street, Suite 1600 Minneapolis, MN 55402-1436 Contact: Corry Orvis 612-333-3182 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. Insured: COMPANIES AFFORDING COVERAGE Park Construction Company Company Letter A Reliance Insurance Company Attn: Marie McLaughlin Company Letter B Westchester Fire Ins. Cofiri-City Brokerage, Chicago 5802 Franklin, Suite 107 Company Letter C Denver, CO 80216 Company Letter D Company Letter E 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 TO ALL TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR Type of Insurance Policy Number Policy Effective Date Policy Expiration Date Limits General Liability General Aggregate $ 2,000,000 Products -Comp Ops Agg. $ 1,000,000 A NCommercial General Liability VO855533402 4-1-97 4-1-98 Personal & Adv. Injury $ 1,000,000 ❑ Claims Made O Occur. Each Occurrence $ 1,000,000 ❑ Owner's & Contractor's Prot Fire Damage(any One Fire) $ 50,000 ❑ Med. Expense (Any one Person) $ 5,000 Automobile Liability l7 Any Auto Combined Single Limit $ 1,000,000 O All Owned Autos © Scheduled Autos VQ855533502 4-1-97 4-1-98 Bodily Injury (Per Person) $ A © Hired Autos Non Autos Bodily Injury (Per Accident) $ © -Owned ❑ Garage Liability ❑ Property Damage $ Excess Liability Each Occurrence $ 20,000,000 Umbrella Form CUA103692-0 4-1-97 4-1-98 Aggregate $ 20 000,000 B O ❑ Other than Umbrella Form Statutory $ 500,000 CO f Limits Worker's Compensation WD855533302 4-1-97 4-1-98 Each Accident and Disease - Policy Limit $.. _. 500,000 A Employers' Liability Disease- Each Employee $ 500,000 Other DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL It is hereby agreed that the certificate holder is included as Additional by the named insured. CERTIFICATE HOLDER Weld County, Colorado c/o The Board of Count Commissioners of the Y County of Weld ITEMS Insured under the General Liability and Automobile Liability policy as respects work performed CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY 915 Tenth St. Greeley, CO 80631 KIND UPON THE COMPANY, ITS AGENTS OR REPRE�Arcrtr .. ba or 04/6Mq ier AUTHORIZED REPRESENTATIVE 970723 ACORD 25-S (7/90) parkdenv.dot
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