HomeMy WebLinkAbout990746.tiff ACORD CEF2TIF=ICATE OF LIABILITY INSURANCEEPpID MP
DATE(MM'DDYY)
.. LESMA 1 04/02/99
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Linden/Bartels & Noe Agency - HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
3459 W 20th Street Suite 114 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Greeley CO 80631 COMPANIES AFFORDING COVERAGE
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Phone No. 970-356-1133 Fax No. 970-356-4088 A Bituminous Insurance Co
INSURED
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Lee Matson Construction, Inc. COMPANY
Les Matson C
PO Box 1830 COMPANY
Greeley CO 80632 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 TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE(MMIDD/VY) DATE(MM/DD/YV)
GENERAL LIABILITY GENERAL AGGREGATE $ 2,000,000
A ', X COMMERCIAL GENERAL LIABILITY CLP2315005 04/01/99 04/01/00 PRODUCTS-COMP/OPAGG $ 2,000,000
CLAIMS MADE LXJ OCCUR PERSONAL B ADV INJURY $ 1, 000,000
OWNER'S B CONTRACTOR'S PROT EACH OCCURRENCE $ 1, 000, 000
— I FIRE DAMAGE(Any one fire) $ 100, 000
MED EXP(Any one person) $ 5, 000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000, 000
A X ANY AUTO CAP2550219 04/01/99 04/01/00
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS (Per person)
11 HIRED AUTOS
-_ BODILY INJURY
NON OWNEDAUTOS (Per accident)
------ PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY EA ACCIDENT $
ANY AUTO N/A OTHER THAN AUTO ONLY. _ --,.-
_. EACH ACCIDENT $-- _ -- —
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $ 1, 000,000
A X I UMBRELLA FORM CUP2526060 04/01/99 04/01/00 AGGREGATE - S 1, 000, 000 OTHER THAN UMBRELLA FORM ' $
WC WORKERS COMPENSATION AND ORY LIMIT
0TH
T
EMPLOYERS'LIABILITY ORV LMITTS EF.�_
EL EACH ACCIDENT $
THE PROPRIETOR/ INCL N/A EL DISEASE POLICY LIMIT $
PARTNERS/EXECUTIVE --+-- - — - -----
OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE) $
OTHER
A RIGGING FLTR CLP2315005 04/01/99 04/01/00 $1000 DED $250, 000
A LEASED/RENT EQUIP CLP2315005 04/01/99 04/01/00 BLANKET $250,000
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
RE: REHABILITATION OF BRIDGE ABUTMENTS.
CERTIFICATE.HOLDER :CANCELLATION
WCBOAR1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Board of Weld County 10__DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LE-T.
Commissioners/Purchasing Dept BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
915 10th Street Room 200
Greeley CO 80632 OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
757-a �� ��� ACORD CORPORATION 1988
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