HomeMy WebLinkAboutHEIMBUCK DISPOSAL - INSURANCE CERTIFICATEACORD HEIMB-1 10 14 04 CERTIFICATE OF LIABILITY INSURANCE B DATE(/14/04
IMB
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Renaissance Insurance Group HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
631 Birch Street, Unit D
Windsor CO 80550
Phone:970-674-8825 Fax:970-674-8826
Heimbuck Disposal, Inc.
Tim Heimbuck
PO Box 270310
Fort Collins CO 80527
INSURERS AFFORDING COVERAGE
INSURER A: Allied Insuranc
INSURER 8: Employers COmpE
INSURER C:
INSURER D:
NAIC #
IIVVCR "Mo
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
NSRrGENERALLIABILITY
NSURANCE
POLICY NUMBER
DATE MM/DOm E
DATE MM/DO/YY TION
LIMITS
EACH OCCURRENCE
E1000000
PREMISES (Eaoccur )
E100000
A
GENERALLIABILITV
ACpMCT07511662675
11/Ol/05
11/O1/06
MED EXP (Any one person)
s5000
ADE OCCUR
PERSONAL&ADV INJURY
s1000000
GENERAL AGGREGATE
E2000000
LIMIT APPLIES PER:
PRODUCTS-COMPIOP AGG
s2000000
PRO-
X POLICY JECT LOC
A
AUTOMOBILE
LIABILITY
ANY AUTO
ACPBA7511662675
11/01/05
11/01/06
COMBINED SINGLE LIMIT
(Ea accident)
E 1000000
X
BODILY INJURY
(Per person)
E
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Per accident
$
HIRED AUTOS
AUTOS
XNON-OWNED
PROPERTY DAMAGE
(Per accident)
E
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
E
ANY AUTO
$
AUTO ONLY: AGG
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
E
AGGREGATE
E
OCCUR El CLAIMS MADE
E
E
DEDUCTIBLE
E
RETENTION E
WORKERS COMPENSATION AND
TORY LIMITS I X I ER
E.L.EACHACCIDENT
s500000
B
EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED?
FN-329393-01
08/01/06
08/01/07
E.L. DISEASE - EA EMPLOYEE
s 500000
E.L. DISEASE - POLICY LIMIT
E 500000
Use, describe under ECIAL PROVISIONS below
SP
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
City of Fort Collins
Attn: Linda
P.O. Box 580
Fort Collins CO 80522
GANGtLLA 11 V N
CTYFTCO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES,
AUTHORIZED REPRESENTATIVE 7 of 7 _ _ _ i
25 (2001/08) 0ACORD CORPORATION 1981