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HomeMy WebLinkAboutLOOS ELECTRIC - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE American Family Insurance Company ❑ American Family Mutual Insurance Company if selection box is not checked. 6000 American Pky Madison, Wisconsin 53783-0001 Insured's Name and Address Agent's Name, Address and Phone Number (Agt./Dist.) Loos Electric Dan C. Mausbach (970) 352-7778 PO Box 699 922 36th Ave. Greeley, CO 80632 Greeley, CO 80634 (120/309) This certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This certificate does not amend, extend or alter the coverage afforded by the policies listed below. COVERAGES This is to certify that 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. TYPE OF INSURANCE POLICY NUMBER POLICY DATE LIMITS OF LIABILITY EFFECTIVE EXPIRATION Mo Da Yr (Mo.Da Yr Homeowners/ Bodily Injury and Property Damage Mobilehomeowners Liability Each Occurrence $ 000 Bodily Injury and Property Damage Boatowners Liability $ Each Occurrence ,000 Bodily Injury and Property Damage Personal Umbrella Liability $ Each Occurrence ,000 Fann Liability & Personal Liability Farm/Ranch Liability Each Occurrence $ 000 Farm Employer's Liability Each Occurrence $ 000 Workers Compensation and statutory .....•.•.•«• Each Accident $ 000 Employers Liability t Disease - Each Employee $ ,000 Disease -Policy Limit $ ,000 General Liability General Aggregate $ 2,000 000 Products-CompletedOperationsA reate $ 2,000,000 ® Commercial General Personal and Advertisino Injury $ 1,000 .000Each Liability(occurrence) 05-X74392-07-00 9/2/2006 9/2/2007 Occurrence $ 1,000 ,000 ❑ Dama a to Premises Rented to You $ 100 000 ❑ Medical Expense (Any One Person) $ 5 000 Each Occurrencet t $ 000 Businessowners Liability $ Aggregatett ,000 Common Cause Limit $ ,000 Liquor Liability Aggregate Limit $ 000 Automobile Liability Bodily Injury - Each Person $ 1,000,000 ❑ Any Auto ID All Owned Autos Bodily Injury -Each Accident $ 1,000 ,000 Property Damage $ 250 ,000 © Scheduled Autos 05-X31817-04-00 8/11/2006 8/11/2007 ❑ Hired Auto Bodily Injury and Property Damage Combined $ 000 ❑ Nonowned Autos ❑ Excess Liability ❑ Commercial Blanket Excess 05-X74392-08-00 9/2/2006 9/2/2007 Each Occurrence/Aggregate $ 1,000 ,000 ® Commercial Liability Umbrella Other (Miscellaneous Coverages) DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / RESTRICTIONS / SPECIAL ITEMS t The individual or partners shown as insured ❑ Have ❑ Have not elected to be covered as employees under this policy. tt Products -Completed Operations aggregate is equal to each occurrence limit and is included in policy aggregate. CERTIFICATE HOLDER'S NAME AND ADDRESS CAMCELLATIDN Should any of the above described policies be cancelled before the • expiration date thereof, the company will endeavor to mail '( days) written notice to the Certificate Holder named, but failure to mail such City of Fort Collins y notice shall impose no obligation or liability of any kind upon the company, its aghents or representatives. *10 days unless different PO Box 580 number of days s own. Fort Collins, CO 80522 ® This certifies coverage on the date of issue only. The above described policies are subject to cancellation in conformity with their terms and by the laws oft a of issue. DATE ISSUED AUTHOR REPRE TATIVE 10-23-06 - . L - 1 ` uarn F.+ smn Certificate Holder Rtnn.k Min nssrA Pav 7/1`19