HomeMy WebLinkAbout992588.tiff Client# : 23903 UNITEPOW
I Carla CERTIFICATE OF LIABILITY INSURANCE 0DATE 9/(24/99
PRODUCER +. - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Insurance Network of Texae . ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
107 West Crockett - HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
LaGrange, TX 78945
409 968-6494 - . - - - INSURERS AFFORDING COVERAGE
INSURED INSURER A:Twin City Fire Insurance
United Power, Inc . INSURER B:Hartford Fire Insurance - -
18551 East 160th Avenue ` "
INSURER C:RLI Insurance Company
PO Box 929
INSURER D:
Brighton, CO 80601 INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY 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 THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR POLICY EFFECTIVE POLICY EXPIRATION - -
LTR TYPE OF INSURANCE POLICY NUMBER _ DATErMM/DD/YY)I DATE(MMIDPITY) LIMITS
A GENERAL LIABILITY 134CESQC2734 09/01/98 09/01/01 EACH OCCURRENCE $1, 000, 000
x I COMMERCIAL GENERAL LIABILITY I FIRE DAMAGE(Any one(Ire) $500, 000 _..
' CLAIMS MADEI XI OCCUR MED EXP(Any one person) i$10, 000
PERSONAL BADV INJURY I$1, 000, 000
GENERAL AGGREGATE I$1, 00(1j 000
I
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $1,_000, 000
PRO-
POLICY JECT LOC
B AUTOMOBILE LIABILITY 34CESQC2735 09/01/98 09/0101 COMBINED SINGLE LIMIT
_ ANY AUTO (Ea accident) $1, 000 , 000
ALL OWNED AUTOS BODILY INJURY
X SCHEDULED AUTOS (Per person)
I
X HIRED AUTOS ••
BODILY INJURY
(Per accident) $
X NON-OWNED AUTOS
X Uninsured Motor
PROPERTY DAMAGE
X PIP (Per accident I$
• GARAGE LIABILITY AUTO ONLY-EA ACCIDENT$
ANY AUTO OTHER THAN EA ACC i$
AUTO ONLY: AGO $
C EXCESS LIABILITY OUL0044062 09/01/99 09/01/00 EACH OCCURRENCE $31, 000, 00C
X OCCUR [_. CLAIMS MADE AGGREGATE $31, 000 , 00C
•
$
_ DEDUCTIBLE $
X RETENTION $10 , 000 I • $
TATU- LOTH-
WORKERS COMPENSATION AND TORY IMITS i ER
' EMPLOYERS'LIABILITY
E.L.EACH ACCIDENT $
•
E.L.DISEASE-EA EMPLOYEE$
EL.DISEASE-POLICY LIMIT,$
OTHER
•
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER ADDmONALINSURED;INSURER LETTER __. CANCELLATION
SHOULDANYOFTHEABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION
Weld County of Colorado DATETHEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAI CR O DAYSWRRIEN
P.O. Box 758 NOTICETOTHE CERTIFICATE HOLDERNAMEDTOTIf LEFT,BUTFAILURE TO DO SOSHALL
Greely, CO 80621-0758 IMPOSE NO OBLIGATION OR LIABILITY OFANYKIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES.
AUTH RIZEDREPRE TIV
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SENT/ E �p'-`'¢
ACORD25.S(7/97)1 of 2 #532114/M32103 I I ��r`631
992588
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IMPORTANT
If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or after the coverage afforded by the policies listed thereon.
AC0RD25-S(7/97)2 of 2 #S32114/M32103
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