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Home My WebLink About20141068.tiff I 309561 ® AC R DATE IMMIDD/YYTY) CERTIFICATE OF LIABILITY INSURANCE 3/21/2014 4%...----. 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(les) 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 FAX _LNc No Ea 720-528-7589 Ira Not 855-669-8729 Wells Fargo Insurance Services USA, Inc. RECEIVED ADDRESS: amber.m.hernandez@wellsfargo.com 5600 South Quebec,Suite 300B INSURER(S)AFFORDING COVERAGE NAM 7 Greenwood Village,CO 80111-2225 INSURER A Travelers Indemnity Company 25658 -MAR INSURED INSURER B: Travelers Property Casualty Co of America 25674 JAB Wireless, Inc. COUNTY INSURER C 400 Inverness Parkway,#330 cilWSSIONERS INSURER D: _. INSURER E: Englewood,CO 80112 INSURER F: COVERAGES CERTIFICATE NUMBER: 7468217 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MIWDCDNYYY) IMM/0DIYIIY) LIMITS LTR POD WIND J X COMMERCIAL GENERAL LIABILITY HK6303D8146221ND13 08/01/2013 O8/O1/2O14 EACH OCCURRENCE 5 1.000,000 A _T- DAMAGE TO RENTED _ICLAIMS-MADE LX OCCUR PREMISES(ea occurrenceL_S 300000_. MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: - GENERAL AGGREGATE $ 2,000,000 X POLICY[ J ,E/°T [ - ] LOC PRODUCTS-COMP/OP AGG S 2000,000 OTHER: $ D SINGLE LIMIT B AUTOMOBILE LIABILITY HJCAP117Da'765TIL13 08/01/2013 1 � 08/01/2014 ;COMBINE(Ea accident $ t000.DBo X ANY AUTO BODILY INJURY(Per person) $ - — — _— ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS x AUTOS (Per acciden0 $ _—_ S B X UMBRELLALIAB I X OCCUR HSMJCUP117O6777TIL13 08/01/2013 08/01/2014 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB 1 CLAIMS-MADE AGGREGATE $ 1,000,000 IA DEDTr X RETENTIONS 0 $ OT - B WORKERS COMPENSATION HRJUB157D316813 08/01/2013 08/01/2014 xLSTAT LITE I ERH AND EMPLOYERS'LIABILITY YIN 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE NIA EL.EACH ACCIDENT - $ _ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) EL DISEASE_EA EMPLOYEE $ _ - 1,0(10,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000.000 F DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached II more space Is required) If required in written contract or written agreement,reement,the certificate holder is named as additional insured for ongoing operations with regards to eq generalliability.Site Location 18940 CR 38 Platteville,CO 80651 2014-1068 CERTIFICATE HOLDER CANCELLATION Weld County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Clerk for the Board of County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 758 Greeley,CO 80632 AUTHORIZED REPRESENT/41SE The ACORD 25(20194/01) ACORD name and logo are registered ll marks of IAICIpIOR1DD ©1988-2014 ACORD CORPORATION. All rights reserved. NE 5...�'��C/y T/1 IItlW III IIIIIN/III I��II VIII II INI VIII NII II III VIII VIII III .NII I�I Ilal tY801/421/000143/02102/010/0/0' Hello