HomeMy WebLinkAboutHIGH COUNTRY PIPELINE CONTRACTORS - INSURANCE CERTIFICATEClian4$- 227R7
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ACORDTM CERTIFICATE OF LIABILITY INSURANCE
DATE "
09122/06D
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Van Gilder Insurance Corp (CS)
24 South Weber, Suite 200
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Colorado Springs, CO 80903
719 634-8807
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
High Country Pipeline Contractors, Inc
P.O. Box 208
Penrose, CO 81240-0208
INSURERA: Bituminous Insurance Companies
INSURERS: National Union Fire Ins Co of Pitts-
INSURERC: Pinnacol Assurance
INSURERD: Fireman's Fund Insurance Company
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
N R
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MMIDDIYYI
POLICY EXPIRATION
DATE
LIMITS
A
GENERAL LIABILITY
CLP3233717
09/25/06
09/25/07
EACH OCCURRENCE
$1 000000
X COMMERCIAL GENERAL LIABILITY
DAMAGE TC RENTEDnosl
PREMISES (Ea
$300OOO
MED EXP (Any one person)
$$ 000
CLAIMS MADE Q OCCUR
PERSONAL SADVINJURY
$1000000
X PDDed:1,000
GENERAL AGGREGATE
$2 000 000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
s2.000.000
POLICY51 PR7 LOC
A
AUTOMOBILE LIABILITY
ANY AUTO
CAP3507811
09/25/06
09/25/07
COMBINED SINGLE LIMIT
(Ea accident)
$1,000rODO
BODILY INJURY
(Per Person)
$
ALL OWNED AUTOS
X SCHEDULED AUTOS
X HIRED AUTOS
X NON -OWNED AUTOS
BODILY INJURY
(Per aocident)
$
PROPERTY DAMAGE
(Per aocident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
B
EXCESS/UMBRELLA
LIABILITY
OCCUR CLAIMS MADE
BINDER420209
09/25/06
09/25/07
EACH OCCURRENCE
s5,000.000
X
AGGREGATE
$5 000 000
$
RDEDUCTIBLE
$
X
$
RETENTION $ 0
C
WORKERS COMPENSATION AND
4014538
10/01/06
10/01/07
X TWO STALIMTU- OTH-
FR
ORYEMPLOYERS'
LIABILITY
ANY PROPRIETORIPARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$1 000000
E.L. DISEASE - EA EMPLOYEE
$1 000000
OFFICERIMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE -POLICY LIMIT 1$1,000,000
D
OTHER Comml Inland
98474255
09/25/06
09/25/07
Limit: $450,000
L/R Equipment
Ded: $1000
DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
10 Day written cancellation for non-payment of premium.
RE: Fort Collins Utilities
City of Fort Collins, Water Utilities
Attn: Project Manager
P.O. Box 580
Fort Collins, CO 80522
LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL R0_ DAYS WRITTEN
E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR
ACORD 25120011081 4 of I 1dYdfiR9Rf
REPRESENTATIVE
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