The URL can be used to link to this page

Browse Search

Home My WebLink About20161760.tiffOATH OF OFFICE STATE OF COLORADO, WELD COUNTY EATON FIRE PROTECTION DISTRICT § 32-1-901, C.R.S. I, Ben Bowden , will faithfully support the Constitution of the United States and of the State of Colorado, and the laws made pursuant thereto, and will faithfully perform the duties of the office of Director of the Eaton Fire Protection District upon which I am about to enter. Subscribed and sworn to before me this 16th day of May, 2016. By: Or (signature) atow-,4A Lyle Brownlee, Pr6�ddent of the Board of Directors) IF SWORN OR AFFIRMS BEFORE A NOTARY THE FOLLOWING SHOULD BE COMPLETED. STATE OF COLORADO ) ss. COUNTY OF Subscribed and sworn to before me this day of , 2016. (Notary commission expiration) (Notary signature) 2016-1760 SD OO&20 OATH OF OFFICE § 32-1-901, C.R.S. STATE OF COLORADO, WELD COUNTY EATON FIRE PROTECTION DISTRICT I, Jeremy Paris , will faithfully support the Constitution of the United States and of the State of Colorado, and the laws made pursuant thereto, and will faithfully perform the duties of the office of Director of the Eaton Fire Protection District upon which I am about to enter, Subscribed and sworn to before me this 16th day of May, 2016. By: Lyle Brownlee, Pres dent of the Board of Directors) Or IF SWORN OR AFFIRMED BEFORE A NOTARY THE FOLLOWING SHOULD BE COMPLETED. STATE OF COLORADO ) ss. COUNTY OF Subscribed and sworn to before me this day of 2016. (Notary commission expiration) (Notary signature) e OATH OF OFFICE STATE OF COLORADO, WELD COUNTY EATON FIRE PROTECTION DISTRICT § 32-1-901, C.R.S. Michael Carrasco , will faithfully support the Constitution of the United States and of the State of Colorado, and the laws made pursuant thereto, and will faithfully perform the duties of the office of Director of the Eaton Fire Protection District upon which I am about t• en Subscribed and sworn to before me this 16th day of May, 016. By: Or Lyle Brownlee, C (signature) i eBoa(of Di Pr 'den of the Board Direc ors) IF SWORN OR AFFIRMED BEFORE A NOTARY THE FOLLOWING SHOULD BE COMPLETED. STATE OF COLORADO COUNTY OF Subscribed and sworn to before me this ) ss. day of , 2016. (Notary commission expiration) (Notary signature) re( I. ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MWDO/YIYY) 5/26/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the polls -Wes) must be endorsed. 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). PRODUCER F&W Insurance 3005 Center Green Drive. Suite 120 Boulder CO 80301 CONTACT PLAN PHONE FAx .yarL„ F., 970-686-7120 ,uc,Nd)' 970-686-7131 _ADDRESS. INSURERIR) AFFORDING COVERAGE MC* INSURER A:AmeriCen Alternative Insurance Corp 19720 INSURED Eaton Fire Protection District 312 Collins St Eaton CO 80615 INSURER B :Pinnace' Assurance Company 41190 INSURER C; INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 320945536 • 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. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN18nR TYPE OFWSURANCE INAOSp5� POLICY NUMBER PoIICY EFF WL'2 I POUCT EYYI.IMMIOOIYYYYI PCIJCY EX LIMITS A YNE(LCIALGENEFAL LwBINrY VFlB-TR-206639&01 1/1/2016 1/1/201T I ACN OCCURRENCE 51.000,000 CMS'WOE X OCCUR IM u�E 1 NvRANTED FREMISFs (Fa acs M1 ) S1,000.000 ma EXPtMoee person) 510,000 PERSONAL &ACV INJURY 51.000.000 GENT. AGGREGATE LIMIT APPLIES PER GENEARL AGGREGATE 510.000.000 PRODUCTS-COMP/OP AGO 510.000,000 5 A AUTOMOBILE X LABILITY ANYAl1TO ALL OARED HED VFISTR-206833&01 1112016 1/112011 COMBINEDANGLE UNIT Ma av emll 5 1,000,000 BODILY FLURY (Per person) S BODILY DRURY IPSO accident) S PROPERTY DAMAGE (Per accident) S A X X UMBREUA LIAR EXCESS LIAR X OCCUR C(aMSyux VFIS-TR-2068338-01 1/12016 111/2017 EACN OCCURRENCE 51,000.000 AGGREGATE 52000,000 I OED I I RETENTION 5 S B WoRXERS COMPENSATION ANDEMPLOYEFSLUBIYTY YIN ANY PROPPoETOR/PARTNERIIEOITNE OFFICER/mEMSER EXCLUDED? Mandatory WHIG 11yss, d®ateuMer oSCRIPI1ON OF OPERATIONS below NIA 26655 I/1/2016 1/12017 PFR O1H- (STATUTE FM EL EACH ACCIDENT 51.000.000 EL DISEASE -EA EMPLOYEE 51.000,000 EL DISEASE' POUCY LIMIT 51,000,000 A Come VFIS-TR.2068338-01 1/12016 I/1/201T SEE DESCRIPTION OF OPERATIONSI LOCATIONS IVEHICLES (ACORO IDI.AddIonal Remarks Schedule. may be attached II morn space is required) PEBB: Directors (4) @ $1,000 each, Treasurer (1) @ $5,000 each, Office Manager $5,000 each All with faithful performance CERTIFICATE HOLDER Informational Purposes Only rP c/o Eaton Fire Protection District 312 Collins Street Eaton CO 80615 USA SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AVOW RED REPRESENTATIVE ACORD 25 (2014(01) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Hello