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HomeMy WebLinkAboutHEIMBUCK DISPOSAL INC - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE OF ID DATE(MM/DDNYYY) HEIMB-1 10 14 04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Renaissance Insurance Group HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1625 Pelican Lakes Point ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Windsor CO 80550 Phone:970-674-8825 Fax:970-674-8826 INSURERS AFFORDING COVERAGE NAIC9 [NSURER AURER BHeimbuck Disposal, Inc.Tim Heimbuck URER CPO Box 270310 URERD: Fort Collins CO 80527 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 AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATEYMMIDDIYY DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIALGENERAL LIABILITY ACPXCT07501662675 11/01/04 11/01/05 PREMISES (Ea occurence) $100,000 CLAIMS MADE 1XI OCCUR MED EXP (Any one person) $ 5 , 000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $2,000,000 X POLICY PRO LOC JECT A AUTOMOBILE LIABILITY ANY AUTO ACPBA7501662675 11/01/04 11/01/05 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIRED AUTOS NON-OWNEDAUTOS X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ a $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TORY LIMITS ER E.L. EACH ACCIDENT $ ANY PROPRIETORIPARTNERfEXECUTIVE E.L. DISEASE - EA EMPLOYEE E OFFICERIMEMBER EXCLUDED? yes, antler E.L. DISEASE -POLICY LIMIT $ S ALPRdescribe SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS This certificate is provided in accordance with the above policy issued for the named insured. Limits shown may have been reduced by paid claims. CERTIFICATE HOLDER CANCELLATION FTCPURC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fort Collins Purchasing Division DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Ed Bonnette IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR P.O. BOX 580 REPRESENTATIVES. Fort Collins CO 80525 AUTHORIZED REPRESENTATIVE Jay W. Helz(r +i.vlcv cD (zDDT/0a) ©ACORD lSORPORATION 1988 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 insurer(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. rwv as Jwv uvol