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HomeMy WebLinkAbout128247 PIONEER SAND COMPANY INC - INSURANCE CERTIFICATE (5)A-02Rqa OF
LIABILITY
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INSURANCE 02/
%or.RTIFICAiTE
PRODUCER
5108
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Wells Fargo Insurance
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR
Services Mountain West Inc
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
COMPANIES AFFORDING COVERAGE
Dept 1775
COMPANY
Denver CO $0291-1775
(719) 592-1177
A Wausau Underwriters Ins Co
INSURED
COMPANY
Pioneer Sand Company Inc
B Arch Specialty Insurance Co
COMPANY
Pioneer Landscaping Materials
PO Box 7650
Ci Pinnacol Assurance
COMPANY
Colorado Springs CO 80933
D Fireman s Fund Insurance Co
COVERtAGE$
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED
BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED NOTWITHSTANDINGANYREOUIREMENT TERMORCONDITIONOFANYCONTRACTOROTHERDOCUMENTWITHRESPECTTOWHICHTHIS
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 CLAIMS
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICYEFFECTIVE
DATE(MMIDDIYY)
POLICY EXPIRATION
DATE(MMIDOIYY)
LIMITS
A
GENERAL
LIABILITY
TBJZ91439861039
1/01/08
1/01109
GENERAL AGGREGATE
$ 2 000 000
X
PRODUCTS COMP/OP AGG
$ 2 000 000
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE [X ] OCCUR
PERSONAL & ADV INJURY
$ 1 000 000
EACH OCCURRENCE
$ 1 000 000
OWNERS & CONTRACTORS PROT
FIRE DAMAGE (Any one fire)
$ 100 000
MED EXP (Any one person)
$ 5 000
A
AUTOMOBILE
LIABILITY
ASJZ91439561028
1/01/08
1/01/09
COMBINED SINGLE LIMIT
$
X
ANY AUTO
2 000 000
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON OWNED AUTOS
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
$
GARAGELIABILITY
AUTO ONLY EA ACCIDENT
$
ANY AUTO
OTHER THAN AUTO ON Y
EACH ACCIDENT
$
AGGREGATE
$
g
EXCESSLIABILITY
ULP000226503
1/01/08
1/01/09
EACH OCCURRENCE
$ 10 000 coo
X UMBRELLA FORM
AGGREGATE
$ 10 000 000
$
OTHER THAN UMBRELLA FORM
C
WORKERS COMPENSATION AND
EMPLOYERS LIABILITY
4018785
2/01/09
2/01/09
WC STAi± EOTH
R
EL EACH ACCIDENT
$ 500 000
THE PROPRIETOR/ INCL
PARTNERS/EXECUTIVE X
EL DISEASE POLICY LIMIT
$ 500 000
EL DISEASE EA EMPLOYEE
S Soo 000
OFFICERS ARE EXCL
OTHER
D
Inland Marine/Property
MX198476005
1/01/08
1/01109
S10 000 000 / $5 000 Ded
D
Leased 8 Rented Equipment
li 98476005
1101/08
1/01/09
S 1 000 000 / $5 000 Oed
0
1 Motor Caro Legal Liab
I MX198476005
1/01108
1101109
1 S 100,000 / $5 000 Oed
DESCRIPTION OF OPERATIONSILOCATIONSIWHICLESISPECIAL ITEMS
RE Bid #5148 Infield Soil Mix
ACERT$FiCATIEHIOLDER
CANICELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of Ft Col I ins
EXPIRATION DATE THEREOF THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
P 0 Box 580
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT
Ft Collins CO 80522-0580
BUT F LURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF Y KIND UPON THE C PANY ITS AGENTS OR REPRESENTATIVES
AUTH REPRESENTA IV
tephanis Stegner 100520
ACORD:20 S 1M
CACORD COAPARATiON 1000
CERTIFICATE 205/001/ 00176