HomeMy WebLinkAbout129302 HAGEMAN EARTH CYCLE - INSURANCE CERTIFICATEACGtcD� CERTIFICATE OF LIABILITY INSURANCE
DATE
/03/lii°�"'"'
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4821 Wheaton Drive
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P O Box 270370
Fort Collins, CO 80527
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
Hageman Earth Cycle, Inc.
Hageman Enterprises, LLC
3501 E. Prospect Street
Fort Collins, CO 80525
INSURER A: Continental Western Group
INSURER B:
INSURER C:
INSURER D:
INSURER E:
COVERAGES
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.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MFFE
POLICY EXPIRATION
DATE EXPIRATION
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE Ex-1 OCCUR
X PD Ded:500
CWP2344893
12/01/06
12/01/07
EACH OCCURRENCE
$1 000 000
DAMAGE TO RENTPREMISE (Ea 'mED
$100 000
MED EXP (Any one person)
$5 000
PERSONAL &ADV INJURY
$1000000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO LOC
JECT
PRODUCTS - COMP/OP AGO
s2,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULEDAUTOS
HIREDAUTOS
NON-OWNEDAUTOS
CWP2344893
12/01/06
12/01/07
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
$
OTHERTHAN EA ACC
AUTO ONLY: AGG
$
$
A
EXCESS/UMBRELLA LIABILITY
X OCCUR F1 CLAIMS MADE
XIDEDUCTIBLE
RETENTION $ 10 000
C.U2361408
12/01/06
12/01/07
EACH OCCURRENCE
$1 000 000
AGGREGATE
$1 000 000
$
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED?
It yes, describe under
SPECIAL PROVISIONS below
WC STATU- OTH-
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Re: Snow Removal
City of Fort Collins
Purchasing Department
256 W. Mountain Ave.
Fort Collins, CO 80521
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _3g_ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
ACORD 25 (2001/08) 1 of 2 #M368518
AUTHORIZED
IK
1988
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
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