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HomeMy WebLinkAbout180828 COLORADO BORING - INSURANCE CERTIFICATEACORDM CERTIFICA OF LIABILITY INSUF CE DATE mI 71 I 10/011999 PRODUCER (303) 623-7340 FAX (303)623-2742 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION =entern�al Insurance Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 910 15th St #320 ALTER THE COVERAGE IAFFORDED BY THE POLICIES BELOW Denver, CO 80202 COMPANIES AFFORDING COVERAGE COMPANY NAUTILUS INS 'COMPANY Attn Ext A I INSURED Colorado Boring COMPANY American States B � Jacobs Investment, LLC Pinnacol Assurance 405 North NCR 3 COMPANY c Ft Collins, CO 80524 COMPANY D COVERAGES THIS IS TO CERTIFY THAT 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 LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID GAITS CO TYPE OF INSURANCE POLICY NUMBER LTR POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE IMM/OD/YY) DATE(MMIDDf/Y) GENERAL LIABILITY GENERAL AGGREGATE $ 2,000,00 X COMMERCIAL GENERAL LIABILITY PRODUCTS - COMPIOP AGG $ 1,000,000 A CLAIMS MADE X OCCUR NS080972 07/23/1999 07/23/2000 PERSONAL & ADV INJURY $ 1,000,000 OWNERS&CONTRACTORS PROT EACH OCCURRENCE S 1,000,000 FIRE DAMAGE (Any ane bra) S 50,000 MED EXP (Any one person) $ 5,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ X ANvnuro 500,000 ALL OWNED AUTOS BODILY INJURY $ B SCHEDULED AUTOS 010E63254401 07/23/1999 07/23/2000 (Per person) HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Par accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANYAUTO OTHER THAN AUTO ONLY EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY ( EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE 8 OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS LIABILITY C 4021687 07/26/1999 08/O1/2000' EL EACH ACCIDENT $ 100,000 — THEPROPRIETOR/ INCL EL DISEASE POLICY LIMIT $ 50O,000 PARTNERS/EXECUTIVE OFFICERS ARE EXCL EL DISEASE EA EMPLOYEE $ 100,000 OTHER I DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESISPEOIAL ITEMS 1 ERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED UNDER THE GENERAL LIAIBILITY COVERAGE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE I EXPIRATION DATE THEREOF THE ISSUING COMPANY WILL ENDEAVOR TO MAIL TEN DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT CITY OF FT COLLINS BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY P 0 BOX 580 OF ANY KIND UPON THE COMPANY ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE 1 FT COLLINS, CO 80522-0580 David Swanson/DAVE ACORD 25S (1/95) ©ACORD CORPORATION 1988 'AQRD„ CERTlFIC OF LIABILITY INSUP ACE DATE IMMIDO YY) = I /07/1999 PRODUCER (303)623-7340 FAX (303)623-2742 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION :ent@rni al Insurance Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 910 15th St #320 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Denver, CO 80202 COMPANIES AFFORDING COVERAGE COMPANY NAUTILUS INS COMPANY Attn Ext A INSURED Colorado Boring COMPANY American States B Jacobs Investment, LLC Pinnacol Assurance 405 North NCR 3 COMPANY C Ft Collins, CO 80524 COMPANY D COVERAGES THIS IS TO CERTIFY THAT 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 DESCRIBEDIHEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS I CO TYPE OF INSURANCE POLICY NUMBER LTR POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE(MMIDD/(Y) DATEIMWODfIY) GENERAL LIABILITY GENERAL AGGREGATE $ 2,000,000 X COMMERCIAL GENERAL LIABILITY PRODUCTS COMP/OP AGG $ 1,000,000 A CLAIMS MADE X OCCUR NS080972 07/23/1999 07/23/2000 PERSONAL B ADV INJURY $ 1,000,000, OWNER S S CONTRACTOR S PROT EACH OCCURRENCE $ 1,000,0001 FIRE DAMAGE (Any one lee) $ 50,000 MED EXP (Any one person) $ 5,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S X ANY AUTO 500,000 ALL OWNED AUTOS BODILY INJURY $ B SCHEDULED AUTOS OICE63254401 07/23/1999 07/23/2000 (Per person) HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTOONLY EAACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM I AGGREGATE $ OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS LIABILITY C 4021687 07/26/1999 08/01/2000 ELEACHACCIDENi $ 100, 00C - THE PROPRIETOR/ INCL EL DISEASE POLICY LIMIT It SOO , OOC PARTNERSIEXECUTIVE OFFICERS ARE EXCL EL DISEASE EA EMPLOYEE $ 100,00C OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESISPECIAL ITEMS ERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED UNDER THE GENERAL LIABILITY COVERAGE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL TEN DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, CITY OF FT COLLINS BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY P 0 BOX 580 OF ANY KIND UPON THE COMPANY ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE FT COLLINS, CO 8OS22-0580 David Swanson/DAVE ACORD 25S (1195) ©ACORD CORPORATION 191