HomeMy WebLinkAbout760464.tiff GENERAL INSURANCE C.c)M,faANY OF AMERICA 9T T ' /
Home Office: 4317 Brooklyn Are. N.E., Seattle, N JP IBS (A Stock Insurance Company) SAFECo
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INgUnANCE
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Certificate of Insurance
General Insurance Company of America hereby certifies that such insurance policies as are indicated hereunder have been
issued and are in full force and effect on the effective date of this certificate.
Name of Insured and Mailing Address (Street, City, State)
r
Mr. James P. Conner &
Mr. Richard C. McCoy
468 Oswego Street
Aurora, Colorado
L J
Policy Period: from 1 13-76 to 1 13 77
12:01 A.M., Standard Time, at the address of the insured shown above.
This certificate indicates insurance afforded only with respect to such and so many of the policies of insurance as are in.
- dicated by number herein, and to such and so many of the coverages under such policies as are indicated by the inclusion of limits of liability, amount of coverage or the word "Included".
This certificate is only a statement of the existence of the policy or policies of insurance herein referred to and does not
change or affect the terms thereof.
Type of Insurance Policy Number Caperaye Llmlte of Liability or Amount of Conran
Public Liability One Person
Bodily Injury One (Accident)(Occurrence)
Other Than
One
Auto or Elevator 1,1Agg Accident
Property Damage Aggregate
Auto One Person
Public Liability Bodily Injury One (Accident)(Occurrence)
Property Damage One (Accident)(Occurrence)
Workmen's Subjectto,(le terms of the Workmen's
Compensation Compensation laws of the state in
which policy affords coverage.
FIRE CP655200 Builders Risk covering $175,000. Fire,EC, & V$lMS
1027 16th St.,Oreely,Colo.
One Person
One(AccidentxOccurrence)
Aggregate
One (Accident)(Occurrence)
Location of risk covered, or description of automobile or elevator covered, or description and location of operations or
work covered:
I I This policy provides Products and Completed Operations coverage.
Certificate is issued to: Name and Address Dated
at (j// /fame �La.
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Weld County �7
Greely,P. O. Box 758 p�� onllrli �� ��/�p
Colo. 80636 aE AL INSURANCE COMPANY OP AMERICA
By
c.70 R7 4/63 760464
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