HomeMy WebLinkAboutADVANCED PEST MANAGEMENT COLORADO MOSQUITO CONTROL - INSURANCE CERTIFICATE (2)A
CERTIFICATE OF INSURANCE
SUCH INSURANCE AS RESPECTS THE INTEREST OF THE CERTIFICATE HOLDER NAMED BELOW WILL NOT BE
CANCELED OR OTHERWISE TERMINATED WITHOUT GIVING 10 DAYS PRIOR WRITTEN NOTICE TO THE
CERTIFICATE HOLDER, BUT IN NO EVENT SHALL THIS CERTIFICATE BE VALID MORE THAN 30 DAYS FROM
THE DATE WRITTEN. THIS CERTIFICATE OF INSURANCE DOES NOT CHANGE THE COVERAGE PROVIDED BY
ANY POLICY DESCRIBED BELOW.
This certifies that: ® STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY of Bloomington, Illinois
❑ STATE FARM FIRE AND CASUALTY COMPANY of Bloomington, Illinois
❑ STATE FARM COUNTY MUTUAL INSURANCE COMPANY OF TEXAS of Dallas, Texas
❑ STATE FARM INDEMNITY COMPANY of Bloomington, Illinois, or
❑ STATE FARM GUARANTY INSURANCE COMPANY of Bloomington, Illinois
hoe rnvarona in fnrra fnr tha fnllnwina Named Insured as shown below:
NAMED INSURED: ADVANCED PEST MANAGEMENT INC DBA COLORADO MOSQUITO CONTROL
ADDRESS OF NAMED INSURED: 695
N 7TH AVE
BRIGHTON,
CO 80601
POLICY NUMBER
F601683-COI-06H-9
EFFECTIVE DATE
OF POLICY
09/01/06-09/01/07
DESCRIPTION OF
VEHICLE (Including VIN)
FLEET POLICY
LIABILITY COVERAGE
® YES
❑ NO
❑ YES
❑ NO
❑ YES
❑ NO
❑ YES
❑ NO
LIMITS OF LIABILITY
a. Bodily Injury
Each Person
Each Accident
b. Property Damage
Each Accident
c. Bodily Injury &
Property Damage
Single Limit
Each Accident
1,000,000
PHYSICAL DAMAGE
COVERAGES
® YES
[]NO
❑ YES
❑ NO
❑ YES
❑ NO
❑ YES
❑ NO
a. Comprehensive
$ 100
Deductible
$
Deductible
$
Deductible
$
Deductible
® YES
❑ NO
[]YES
[]NO
❑ YES
❑ NO
❑ YES
❑ NO
b. Collision
$ 500
Deductible
$
Deductible
$
Deductible
$
Deductible
EMPCLYBILITSY COVON-OWNEERAGE
CAR LIIA
❑ YES
® NO
❑ YES
❑ NO
❑ YES
❑ NO
❑ YES
❑ NO
HIRED GAR LIABILITY
❑ YES
® NO
❑ YES
❑ NO
❑ YES
❑ NO
❑ YES
❑ NO
COVERAGE
FLEET - COVERAGE FOR
I
®YES
❑ NO
❑ YES
❑ NO
❑ YES
❑ NO
❑ YES
❑ NO
MMOOTOO�
LICENCED REP 1983 11/20/06
Signature of Authorized Representative Title Agent's Code Number Date
Address of Certificate Holder
FORT COLLINS
CITY HALL WEST
300 LAPORTE AVE
FORT COLLINS, CO 80521
Doris Stipech Agency
8100 Ralston Road Ste 131
Arvada, CO 80002
INTERNAL STATE FARM USE ONLY: ❑ Request permanent Certificate of Insurance for liability coverage.
122429.3 Rev. 07-25-2005 ❑ Request Certificate Holder to be added as an Additional Insured.