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Home My WebLink AboutWESTERN STATES LAND SERVICES - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE WESTE Sl DATE 12 M05n07) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Richards, Seeley, 6 Schaefer, ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Inc HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 3640 W. 112 th Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Westminster CO 80031 Phone 303-429-3561 Fax 303-427-0611 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA American States Insurance INSURERB P1nTlano71 AR4v Ynlnnn Western States Land Services IN"UHEHL 505 N Denver Avenue INsuRERD Loveland CO 80537 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 AIJD CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MA) HAVE BEEN REDUCED BY PAID CLAIMS INSR LT ADD L NERD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE IMM/DD/YY) POLICY EXPIRATION DATE IMMIDD/YYI LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 1XI OCCUR O2-BD-667945—B 12/15/07 1Z/15/06 EACH OCCURRENCE DAMAGE TO RENTEU PREMISES Ea occurence $ 1,000,00 It 250,000 MED EXP (Any one person) $ 10,000 PERSONAL B ADV INJURY $ 1 0001000 GENERAL AGGREGATE $ 2,0001000 GEN L AGGREGATE LIMIT APPLIES PER POLICY n PRO- LOC SECT PRODUCTS .COMP/OP AGO $ 110001000 A AUTOMOBILE LIABILITY ANY Auro ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 02-CD-150124-05 01/30/08 O1/30/0'9 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per acntlent) $ OAR AGE LABILITY ANY ALTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY AGG $ $ —�' EXCESSIUMBRELLA LIABILITY OCCUF ❑ CLAIMS MADE DEDUCTIBLE RETEN rION $ EACH OCCURRENCE It AGGREGATE $ § $ B _ WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETORIPARTNERIE%ECUTIVE OFFICER/MEMBER E%CLUDEOp It describe underSPECIAL PROVISIONS below 1803222 01/01/08 01/01/09 X WC STAID OTH- TORY LIMITS ER EL EACH ACCIDENT $ 100,000 EL DISEASE EA EMPLOYEE $ SOO , OOO EL DISEASE POLICY LIMIT ElOO 000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION CITY019 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN C1ty of Ft Collxns NOTICE TO THE CERTIFICATE HOLDf R NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL Mr O'Neil PO BOX 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR Ft Co111nS CO 80522-0580 REPRESENTATIVES AUTHORIZED REPRESENTATIVE ACORD 25 (2001108) >.;;- b ACOSUZTPPORATION 198 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed A statement 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 insuier(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 ACORD 25 (2001108)