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Home My WebLink About20141238.tiff 309561 A�O® DATE(MMIDO/YYTY) y C CERTIFICATE OF LIABILITY INSURANCE 4/10/2014 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 policy(Ies) 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 CONTACT Amber Hernandez NAME:_ Commercial Lines-(720)528-7600 PHONE - I FAX (A/C,No Ext): 720-528-7589 (NC,No): 655-669-8729 Wells Fargo Insurance Services USA,Inc. E-MAIL -- ADDRESS: amb -., er.m:hernandez@wellsfargo_com 5600 South Quebec,Suite 3006 INSUR£R(S)AFFORDING COVERAGE NA1C p Greenwood Village,CO 80111-2225 INSURER A: Travelers Indemnity Company 25658 INSURED INSURER B: Travelers Property Casualty Co of America 25674 JAB Wireless,Inc.dba JAB Broadband INSURER C: 400 Inverness Parkway,#330 INSURER 0: INSURERE: Englewood,CO 80112 INSURER F: I COVERAGES CERTIFICATE NUMBER: 7587120 REVISION NUMBER: See below 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 1S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 1 TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LTR INSD I MD POLICY NUMBER (MM/DD/YYTY) (MM/DLVYYTY) LIMITS A X `COMMERCIAL GENERAL LIABILITY I HK6303D814622IND13 O8/O1/2O13 08/01/2014 EACH OCCURRENCE $ - 1,000,000 DAMAGE TO(TENTED i CLAIMS-MADE I.X 300,000.I OCCUR ..PREMISES(Ea occurrence) --$ _ _---- --_._. MED EXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ - 2,000,000 X POLICY[ ECT 7. PRODUCTS-COMPIOP AGG $— 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) '$ ALL OWNED SCHEDULED _...__ ------ ...------ --------- ..... - AUTOS __ AUTOS BODILY INJURY(Per accident) $ NON-OWNED — .._ -- HIRED AUTOS PROPERTY DAMAGE $ AUTOS -(Per@ccldenl)- $ B X UMBRELLA LIAB _X OCCUR HSMJCUP117D6777TIL13 08/01/2013 08/01/2014 EACH OCCURRENCE $ 1,000.000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED I X I RETENTIONS 0 $ B WORKERS COMPENSATION HRJUB157D316813 08/0112013r 08101/2014 X ISTAI'UTEJ_ _I.ERH AND EMPLOYERS' YIN 1.000,000 -_._._-__.., AND EMPLOYERS'LIABILITY - ANY PROPRIETORIPARTNER/EXECUTIVE N!A E.L.EACH ACCIDENT i$ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE'$ 1.000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY I_IMI r(S L DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If mom space Is required) If required in written contract or written agreement,the certificate holder is named as additional insured for ongoin o erations with re ards to general liability.Site Location 18940 CR 38 Platteville,Co 80651. C E f V ID APR 16 2014 WELD COUNTY CERTIFICATE HOLDER CANCELLATION COMMISSIONFRS Weld County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Clerk for the Board of County ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 758 • _ Greeley,CO 80632 AUTHORIZED REPRESENTATIVE 2O14_1238 The ACORD name and logo are registered marks of ACORD ©1988-2014 ACORD CORPORATION. All rights reserved. 00064O ACORD 25(2014101) INN I III III III ll I HIM II ll II1II ltl II LIMB •CYeorA:0/0002e0re2ro2ror0roi0• Hello