HomeMy WebLinkAboutHYDRO - INSURANCE CERTIFICATE (20)DATE
ACORQ CERTIFICATE OF LIABILITY INSURANCE fn ,MZ I
Herbert -Leavitt Ft Collins
ZS37 Research Blvd 8100
Fort Collins, CO SOS26
INSURED
6826 N. Franklin
Loveland, CO 8OS38
COVERAGES
THIS CERTIFICATE
INSURERS AFFORDING COVERAGE
INSURER SafeCo
INSURER B. Pinnacol Assurance
INSURER C
NSURER D:
INSURER E.
OF INFORMATION
i CERTIFICATE
END, EXTEND OR
NAIC 11
THE POLICIES OF INSURANCE LISTED BELOW RAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADVIL
TYPE OF INSURANCE
POLICYNUMBER
POLICY EFFECTIVE
DATE (MMII
POLICY EXPIRATION
DATE GIMICIDN"
LMIITS
EACH OCCURRENCE S 1,000,000
A
GENERAL LWBILTY
X COMMERCVALGENERALLIABILTTY
CLAIMSMADE a OCCUR
OICG267672
11/15/2004
11/1S/2005
DAMAZETOPREMSES
MEDEXP(Anyoneperson)
f ZOO, 000
S 10,
PERSONAL & ADV INXIRY
$ 1 000
GENERAL AGGREGATE
$ 2, 000,
GENL AGGREGATE LIMIT APPLIES PER
POLICY jC7 LOC
PRODUCTS - COMPIOP AGG
$ 2,000,00(
AUTOMOBILE
LIABILITY
AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
OWNED AUTOS
COMBINED
�BPtln'NGLE LIMIT
$
BOI]ILYIN,
(Per person))
S
SODLYINLIUNON
(Per e�dw�
$
PROPERTYDAMAGE
(Per=dam)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY- EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
EXCEBSRIMBRELLA UABILm
OCCUR 71 CLAIMS MADE
DEOUCTIBLE
]RETENTION $
EACH OCCURRENCE
$
AGGREGATE
4
$
$
$
B
WORMERS WMIRENSATION AND
EMPLOYERS' UMLm
ANYPROPRIETOR,PARINERIEXECUTIVE
OFFICERMEMBER EXCLUDED?
�EDIAe under
T s,'1ZPROVISIO
L PROVISIONS below
—7
3308161
04/01/2004
04/01/2005
TM*s ont
E.LEACHACCDENi
$ 100
E.L. DISEASE -E0. EMPLOYEE
S 1�
EL. OSEASE-POLICI'LMT IS
S00
OTHER
DESCRIPTION OF OPERAVONSI LOCA79 MIVEHICLESIEXCL<IIIOHB ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
11 Operations/All Locations
City of Fort Collins
Building & Zoning
281 North College Avenue
Fort Collins, CO 80524
SHOULD ANY OF THE ABOVE DESCREED POLES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE MUM INSURER WILL ENDEAVORTOMAIL
_W_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLM NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION Oft LIABILITY
OF ANY KIND UPON THEM URER rtBABENTIORREPRESENTATNES.
NOIIZEDREPRESENTATNE cmAk« ---
acme Littlefield/DEL
AGURD 25 (2001103) OACORD CORPORATION 1988