HomeMy WebLinkAbout106089 WESTERN STATES LAND SERVICES INC - INSURANCE CERTIFICATEACORD J
CERTIFICATE OF LIABILITY INSURANCE CSR S DATE (MhV )
WES11 03 3/06O6
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Richards, Seeley, & Schaefer, ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
3640 W. 112th Avenue
Westminster CO 80031
Phone:303-429-3561 Fax:303-427-0611
Western States Land Services
505 N Denver Avenue
Loveland CO 80537
INSURERS AFFORDING COVERAGE I NAIC #
INSURER A: American States Insurance
INSURERS: Pinnacol Assurance
INSURER C:
INSURER D:
INSURER E:
I,VVCR "Co
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
L T R
NSR
TYPE OF INSURANCE
POLICY NUMBER
DATE MWDD/rr
OW
DATE MMIDD�
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE X❑ OCCUR
02—BO-887945-8
12/15/06
12/15/07
EACH OCCURRENCE
$ 1,000,000
PREMISES (Ea occurence)
$ 250,000
MED EXP (Any one person)
$ 10,000
PERSONAL &ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY JET LOC
PRODUCTS-COMP/OP AGG
$ 1,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON-OWNEDAUTOS
02—CD-150124-05
01/30/07
01/30/08
COMBINED SINGLE LIMIT
(Ea accident)
$1, 000,000
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
EXCESSAIMBRELLA LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
$
$
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETORlPARTNERIEXECUTIVE
OFFICERIMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
1803222
01/01/07
01/01/08
X TORY LIMITS I ER
E.L. EACH ACCIDENT
$100,000
—--"—"--"-
$ 5 0 0 , 0 0 0
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
$ 100,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CERTIFICATE HOLDER A,Nn\,CLL/111Vnt
CITY019 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
City of Ft. Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Mr O'Neil IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
PO Box 580
Ft. Collins CO 80522-0580 REPRESENTATIVES_ -
B J ae
ACORD 25 (2001108) C PORATION 1988