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HomeMy WebLinkAboutWRIGHT BALLARD - INSURANCE CERTIFICATE (3)LES.A. RINGKJOB AGENCY 375 E HORSETOOTH RD BLDG 6 SUITE too FORT COLLINS CO 80525 PHONE 970-223-0940 FAX 970-223-1279 FACSIMILE TRANSMITTAL SHEET 70: FROM: City of Ft Cams Iesa Ringkjob COMPANY: bKrr': . 07/I7/2007 FAX NUMBER: TOTAL NO, OF PAGES INCLUDING COVER: 224-6707 2 PHONE NUMBER. SENDER'S REFERENCE NUMBER: RE: YOUR REPERENCE NUMBER: Wright Ba1,latd Construction ❑ URGENT El FOR REVJFw ❑ PLEASE COMMENT PLLIASE REPLY © PLEASE RECYCLE N OTL- 5/COMMENT$: ATTACHED PLEASE FIND THE CERTIFICATE OF INSURANCE FOR THE CUSTOMER CAPTIONED ABOVE. PLEASE LET US KNOW IF YOU NEED ANYTHING FURTHER. THANKYOU LESA RINGKJOB CERTIFICATE OF LIABILITY INSURANCE American Family Insurance Company M American Family Mutual Insurance Company if selection box Is not checked, 6000 American Pky Madison, Wisconsin 53793.00o1 Insured's Name and Address Agent's Name, Address and Phone Number (AWDist.) Wright Ballard Construction, Inc Lesa Ringkjob 6821 Aaron Drive 375 E. Horsetooth Bldg 6 Ste. 100 Fort Collins, CO 80521 Ft. Collins, CO 80626 This Certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. 7t>lis certificate does not amend, extend or altar the coverage afforded by the policies listed below. ..,:.. '�y p �j � +ra �,`,r.. h. `'�' !• ... ? v i'n ..,,,: i'•...'.,i"i.`, it 4 ,: , ., i 5'..,'.'. ,yFTp Art���II�V,L4r;-. ��.,mT"ry.,'l k�x.'I�!4w.M,q:}'�'Wrf i�...+,Yr, �'r': +y' J r/�, ,F�;",'•ri:,'J,. 5 J 1,,,I . 'J�' Y. I. / .. Li 1,r p,G .�j,F ihy .".}S' This Is to cprtMy that policies or Insurance Fated below have been lesued to the insured named above for the policy period Indicated, noWthatendi g any requirement, term or condition of any contract or other document with respect to which this certlncale may be Issued or may portain, the Insurance afforded by the pdiotes described herein Is "act to all the tens% exduelDna, and cerldlions or such Adidas. POLICY nATF TYPE OF INSURANCE POLICY NUMBER EMFEpCTIVI MA LIMITS OF LIABILITY 'MI HOMDOwners/ scary Inury and Properyl7amage Each Occurrence $ 000 ers Liability Bodily Injury and Property t3amage 5%obliahOffle0wriell'sLiability Eaah Occurrence $ ow Umbrella Liability Bodily Injury and Property Damage Each Occurrence $ 1000 Farm/Ranch Liability Farm Liability & Ph-1 Ua Ilay Each Occurrence $ 000 Farm Employees Liability eacn omurronca 00 Workers Compensation and statutory Employers Liability t 05-XS4845-91 02/18/2007 02/18/2008 Each Accident 100,000 Dle4aee - Each EmPlcyee $ 100 ,P00 oaagsa . Poky Limit $ 500 ,ODD General Liability General Aggregate $ 2,000 o00 ® Commercial General Products - Completed OperationsA to $ 2,000 ow Liability (occurrence) Personal and Advertlaln Injury $ 1,000,000 p 05-X92387-05 12/22/2006 12/22/2007 Eachoedurrence $ 1,000 000 Q Dams o to Promlaae pomad You $ 1 (7� 000 Medical Ex ense cry One Person) $ $ Businessowners Liability .000 Esen Occurrencet t $ 1000 Aggregatett $ '000 Liquor Liability Common Cayce Limo $ 0D0 Aggregate Lima $ .000 Automobile Liability Bodily Injury $ 0 Any Auto - Each Parson 1000 ❑ All Owned Autos Bodily Injury. Each Accldent $ ,000 0 Scheduled Autos ❑ Hired Auto Property Damags $ 000 Cl Nonowned Autos ❑ eodlly Injury and Property Damage Combined $ ,000 Excess Liability ❑ Commercial Blanket (excess Each Occu rrenGg/Aggregate $ El ,D00 Other (Miacellaileoua Coverages) DESCRIPTION OF OPERATION AI TI N / SPECIAL ITEMS The Individual or partners shown as inmrad t P Have ❑Nave not ol=gd to be coverad as amployeea Antler this polioy. t t Products -Completed Operedons aggregate Is equal to each occunance limit and is ln(!ludec In poncy aggregate. GEEt>j�F1OA .E',Hq''(IS.E�t 14NGECC:IrTIf3N 'J . City of Fort Collins Should any of the above described policies be cancelled before the expiratlon date *( Purchasing Dept, th$i eef th company will endeavor to mail days) wrrttan notice to the (:ert'.Vate Holder named, but (allure to mail such 216 N. Mason notice shall Impose no obligation or 11abilii of any kind upon the Ft. Collins, CO 80524 company, Its agenis ar representatives. 0 days unless different number of days shown. ® This certifies coverageWthadibsu9 onl heabdescribed policies are subjn in con(ithterms # 224-fi707DATE and by the laws of theFax Ig,9UEo AU' 07/17/2007 ' U 2D1 Ed. 5100 Certificate Holder Stock No. 6 8 Rev. 7fD2