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HomeMy WebLinkAboutARMADILLO FENCE AND SECURITY - INSURANCE CERTIFICATE (3)Insured's Name and Address Armadillo Fence and Security 229 N Hwy 287 Fort Collins, CO 80524 CERTIFICATE OF LIABILITY INSURANCE American Family Insurance Company ❑ American Family Mutual Insurance Company if selection box is not checked. 6000 American Pky Madison, Wisconsin 53783.0001 Agent's Name, Address and Phone Number (Agt./Dist.) Larry D. Peterson (970) 229-9393 149 W Harvard Street Ste 102 Ft. Collins, CO 80525-2186 (119/309) This certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This certificate does not amend, extend or alter the coverage afforded by the policies listed below. C604"GES This is to certify that 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. POLICY nATE TYPE OF INSURANCE POLICY NUMBER LIMITS OF LIABILITY EFFECTIVE EXPIRATION (Mo. Day. Yr Mo Day, Yr Homeowners/ Bodily Injury and Property Damage Mobilehomeowners Liability Each Occurrence $ 000 Boatowners Liability Body Injury and Property Damage Each Occurrence $ '000 Personal Umbrella Liability Bodily Injury and Property Damage Each Occurrence $ ,000 FarmlRenChLiebilfty Farm Liability & Personal Liability Each Occurrence $ 0()0 Farm Employer's Liability Each Occurrence $ 000 Workers Compensation and Employers Liability t statutory Each Accident $ '000 Disease - Each Employee $ ,000 Disease -Policy Limit $ ,000 General Liability General Aggregate $ 2,000 000 ® Commercial General Liability (occurrence) El Liability 5/21/2004 5/21/2005 Products - ComletedOperationsA r ate $ 2,000,000 Personal and Advertising In'u $ 1,000,000 Each Occurrence $ 1,000,000 Damage to Premises Rented to You $ 100 000 Medical Expense (Any One Person) $ 5 000 Businessowners Liability Each Occurrencet t $ 000 Aggregatett $ ,000 Liquor Liability Common Cause Limit $ ,000 Aggregate Limit $ ,000 Automobile Liability ❑ Any Auto BodilyInjury - EachPerson $ 1,0001000 IM All Owned Autos ❑ Scheduled Autos DO Hired Auto 05-XF9663-02-00 5/21/2004 5/21/2005 Bodily Injury- Each Accident $ 1,000 ,000 property Damage $ 1,000 ,000 ® Nonowned Autos ❑ Boday Injury and Property Damage Combined $ ,000 Excess Liability ❑ Commercial Blanket Excess �" s�6 �� '�, ❑ �"�a, � °'�k`R �>r ; /� J,i f,7,f ��'�a��"%�F r�v� �i�.� ,v; Other (Miscellaneous Coveraces) Each Occurrence/A re ate � g $ ,000 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES /RESTRICTIONS /SPECIAL ITEMS The City of Fort Collins is listed as Additional Insured on the CG 20 10 10 01 endorsement. t The individual or partners shown as insured El Have ❑Have not elected to be covered as employees under this policy. t t Products -Completed Operations aggregate is equal to each occurrence limit and is included in policy aggregate. GERTiFICAfE O CER'SNAMEANlk"ADDRESS,' CAAMGE4UITtON • ADDITIONAL INSURED City of Fort Collins Purchasing Dept. Attn: John Stephen LJ Should any of the above described policies be cancelled before the expiration date thereof, the company will endeavor to mail '( days) written notice to the Certificate Holder named, but failure to mail such notice shall impose no obligation or liabilityy of any kind upon the company, its agents or representatives. 'TO days unless different number of days shown. 215 N Mason Street Fort Collins, CO 80521 IM This certifies coverage on the date of issue only. described policies are subject to cancellation in conformity terms and by the laws of the state of issue. The above with their DATE ISSUED AUTHORIZED REPRE ENTATIVE 9/30/2004 Larry D Peterson U-201 Ed. 5/00 Certificate Holder Stock No. 06668 Rev. 7/02 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 1010 01 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS — SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: tit nu dnuy appears aoove, Imormatlon requires to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section If — Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance aHordee,10 Oecp ad +tfionat irUsuff s, the fnllpwng exclusion is added: 2. Exclusions This insurance does not apply to "bodily injury' or "property damage" occurring after. (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed; or (2) That portion of "your work' out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 10 01 © ISO Properties, Inc., 2001 Stock No 05781