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HomeMy WebLinkAbout485433 JOHNSON TRUCKING - INSURANCE CERTIFICATE4/19/1011 10:29 AM FPAN: Faa Neloh In-. PVT-,, In-. TC: 221:,907 PAGE: 001 OF 001 ^coRr� CERTIFICATE OF LIABILITY INSURANCE DATE 4/07/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to me Certificate holder in lieu of Such endorsement(s). PRODUCER Welsh Insurance Agency. Inc. 4033 Boardwalk Drive. Suite #200 Fort Collins, CO 80525 Phone (970)206-1810 Fax (970)206-1808 CONTACT NAME' Pi°No Est: (070)2!J0�'6-'1810 (IN No): 1970)206-1808 nooRess: Bmcel�xiainsurance com INSURERIS) AFFORDING COVERAGE NAIL S INSURER A United Fire B Casualty INSURED Johnson, Wes, DBA Johnson Trucking - 408 E. 50th Loveland, CO 80538- 970 INSURER B INSURER C: INSURER D: PINNACOL INSURER E INSURER F' COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIESOF INSURANCE LISTED BELOW HAVE BEEN ISSUEDTO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT. TERM OR CONDITION OFANY 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 CLAIMS. INSR LIP TYPE OF INSURANCE ADDLSUBRI INSR WVD -POLICY NUMBER POLICY BEE (MMIDO/YWY) POLICYEXP IMY O/YYY, LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIAbILI I Y ❑ ❑ CLAIM-1,DDE n QCCUIP ❑ Y 60402441 oa/oaro,,, o4/os2o12 EACH OCCUFPBJCE 'DANAGETOPEJTL'D FREIJI5E3(Ea occurrence $ 1, 000,000.00 $ 10Q,000.00 MED E<P(Any one parson) $ 5,000.00 PERsoraa. �s nDv wduer ; 1,000,000 00 ❑ GENERAL ASCPESAIE $ 2,000,000.00 IGEEHL AGGPECA HE LWN APPLIES PER L J POLICY ❑ P 1 ❑ Inc PRoDUcTs, - O:goRoP ASP $ 2,000,000.00 $ A AUTOMOBILE LIABILITY Cl MI1'AUTO L OWNED SCHEDULFD ❑ PLAIJTOS A AUTOS J❑ HIRED AUTOS [] ni rpswNED O UMBRELLA LIAR OnrCLIR EXCESS LIAB ❑ ❑ ttnlMSvADE 60402441 6040244, 04/082011 04/082011 04/082012 04/082012 CEOL01NCD SING E LIMIT $ 1000,00000 BODILY IHi Per person) $ BODILY INJURY (PeracciOxt) 4 Fli aE dent)a�rE A EACH OCCURRENCE $1.000, 000,00 AGGREGATE $ 1,000,000.00 ❑ LED 1/❑ RETENTION $, 10.000.00 g D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y/N ANY PEOPF.IETORfiS4IINEWExEN11VE OFFICEPrMEMBER EXCLUDED? (Mandatory in NH) u yyes, desnoe urns r DESCRIPTIDNOr OPERATIONSLeIOw NIA 9264149 04/082011 03/312012 OTH ,�TCRYLI,'JITS LIER EL EACH ACCIDENT $ 100.000.00 EL DISEASE - EA EMPIOYFf $ 100,000.00 EL DIaEASE-FOIICVLIMIT $ 500,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) TRUCKING CERTIFICATE HOLDER IS AN ADDITIONAL INSURED FOR GL. CERTIFICATE HOLDER City of Fort Collins - PURCHASING DEPARTMENT Attn: Purchasing -Jenny Beck PO Box 580 Fort Collins, CO 80522 fax 221.6707 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) OF The ACORD name and logo are registered marks of ACORD 4/19/1011 10:29 AM FPAN: Faa Neloh In-. PVT-,, In-. TC: 221:,907 PAGE: 001 OF 001 ^coRr� CERTIFICATE OF LIABILITY INSURANCE DATE 4/07/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to me Certificate holder in lieu of Such endorsement(s). PRODUCER Welsh Insurance Agency. Inc. 4033 Boardwalk Drive. Suite #200 Fort Collins, CO 80525 Phone (970)206-1810 Fax (970)206-1808 CONTACT NAME' Pi°No Est: (070)2!J0�'6-'1810 (IN No): 1970)206-1808 nooRess: Bmcel�xiainsurance com INSURERIS) AFFORDING COVERAGE NAIL S INSURER A United Fire B Casualty INSURED Johnson, Wes, DBA Johnson Trucking - 408 E. 50th Loveland, CO 80538- 970 INSURER B INSURER C: INSURER D: PINNACOL INSURER E INSURER F' COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIESOF INSURANCE LISTED BELOW HAVE BEEN ISSUEDTO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT. TERM OR CONDITION OFANY 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 CLAIMS. INSR LIP TYPE OF INSURANCE ADDLSUBRI INSR WVD -POLICY NUMBER POLICY BEE (MMIDO/YWY) POLICYEXP IMY O/YYY, LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIAbILI I Y ❑ ❑ CLAIM-1,DDE n QCCUIP ❑ Y 60402441 oa/oaro,,, o4/os2o12 EACH OCCUFPBJCE 'DANAGETOPEJTL'D FREIJI5E3(Ea occurrence $ 1, 000,000.00 $ 10Q,000.00 MED E<P(Any one parson) $ 5,000.00 PERsoraa. �s nDv wduer ; 1,000,000 00 ❑ GENERAL ASCPESAIE $ 2,000,000.00 IGEEHL AGGPECA HE LWN APPLIES PER L J POLICY ❑ P 1 ❑ Inc PRoDUcTs, - O:goRoP ASP $ 2,000,000.00 $ A AUTOMOBILE LIABILITY Cl MI1'AUTO L OWNED SCHEDULFD ❑ PLAIJTOS A AUTOS J❑ HIRED AUTOS [] ni rpswNED O UMBRELLA LIAR OnrCLIR EXCESS LIAB ❑ ❑ ttnlMSvADE 60402441 6040244, 04/082011 04/082011 04/082012 04/082012 CEOL01NCD SING E LIMIT $ 1000,00000 BODILY IHi Per person) $ BODILY INJURY (PeracciOxt) 4 Fli aE dent)a�rE A EACH OCCURRENCE $1.000, 000,00 AGGREGATE $ 1,000,000.00 ❑ LED 1/❑ RETENTION $, 10.000.00 g D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y/N ANY PEOPF.IETORfiS4IINEWExEN11VE OFFICEPrMEMBER EXCLUDED? (Mandatory in NH) u yyes, desnoe urns r DESCRIPTIDNOr OPERATIONSLeIOw NIA 9264149 04/082011 03/312012 OTH ,�TCRYLI,'JITS LIER EL EACH ACCIDENT $ 100.000.00 EL DISEASE - EA EMPIOYFf $ 100,000.00 EL DIaEASE-FOIICVLIMIT $ 500,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) TRUCKING CERTIFICATE HOLDER IS AN ADDITIONAL INSURED FOR GL. CERTIFICATE HOLDER City of Fort Collins - PURCHASING DEPARTMENT Attn: Purchasing -Jenny Beck PO Box 580 Fort Collins, CO 80522 fax 221.6707 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) OF The ACORD name and logo are registered marks of ACORD