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Home My WebLink AboutJASON WALDO TRUCKING - INSURANCE CERTIFICATEA` OR/7 PRODUCER Nationwide Insurance Mountain Plains Agency 4532 MCMUTry Ave , Suite 150 Ft Collins, CO 80525 INSURED COVERAGES CERTIFICATE OF LIABILITY INSURANCE I DAT11612Dl1^lYV) „/i 6/2007 Jason Waldo 9925 Waldo Ln Wellington, CO 80549-1767 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW INSURERS AFFORDING COVERAGE I NAIC # INSURER A Nationwide Insurance 02358 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 ILTR NSR TYPE OF INSURANCE POLICY NUMBER DATE IMMrtTDIYYE PDATE IMMIDDIYY)N LIMITS X GENERAL LIABILITY COMMERCIAL GENERAL LIAEILITY CLAIMS MADE � OCCUR ACP2603073506 10/31/2007 10/31/2008 EACH OCCURRENCE DAMAGETO RENTED PREMI SES Eaoccurence) $ 2,000000 100 OOD 8____ MEO EXP(Any one person) $ 5,000 PERSONAL S ADV INJURY E 1,000,600 GENERAL AGGREGATE $ 2,000,000 GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS COMPOPAGG E 2,000,000 7x POLICY FJEO LOG E AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea acotleng E BODILY INJURY Per person) E ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY I Per eccltlani) $ HIRED AUTOS NON OWNED AUTOS PROPERTY DAMAGE (Per amtlenl) S GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ S AUTO ONLY ADD EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ $ RETENTION $ WC STATU OTH WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE EL EACH ACCIDENT $ E L DISEASE EA EMPLOYE $ OFFICER,MEMBER EXCLUDED' If yes tlescnbe untler SPECIAL PROVISIONS below E L DISEASE POLICY LIMIT $ OTHER Additional Insured City of Fort Collins, CO DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fort Collins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN 215 N Mason Fort Collins CO 80524 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 REPRESENTATIVES I AUTHORIZED REPRESENTATIVE ACORD 25 (2001108) (J ACORD CORPORATION 1988 IT r• IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed A statment 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 AUUNU ZO tZ1JU11U8j