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Home My WebLink AboutG J WAGNER ENTERPRISES - INSURANCE CERTIFICATE (2)PRODUCER Pinnacol Assurance 7501 E Lowry Blvd DENVER CO 80230-7006 INSURED G & J WAGNER ENTERPRISES INC 14 LETITIA TRAIL RED FEATHER LAKES CO 80545-0397 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 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM AND 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 TERNS. EXCLUSIONS AND CONDITIONS CO I TYPE OF INSURANCE I POLICY NUMBER I POLICIEFFF.CFR'E I POLICY EXPIRATION I LIMITS GENERAL LIABILITY COMMERCLtL GENERAL LIABILITY CLAIMS MADE ❑ OCCUR OWNER'S & CONTRACFOR'S PROT GENERAL AGGREGATE PRODUCTS - COMPIOPAGG PERSONAL & ADY' INJURY EACH OCCURRENCE FIRE DAMAGE tAw w Film MED EXP urc u AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULEDAUTOS HIRER AUTOS NON OWNED AUTOS COMBINED SINGLE LIMIT BODILY" INJURY I uml BODILY INJURY 3CLCI[01 ANY AUTO CESS LIABILITY UMBRELLA FORM WORKERS COMPENSATION ANDNJ wC STATU- U OTHER EMPLOYERS' LIABILPFY TORY LIMITS A 4068533 05/01/2003 05/01/2004 EL RAM ACCIDENT 100000 THE PROPRIETOWPARTNERS- INCL EL DISEASE - POLICY LIMIT "iO5.000 EXECUTIVE OFFICERS ARE: EYCL EL DISEASE - EA EAfPLOYEE c.p IOO OOO OTHER DESCRIPTION OF OPERATIONSILW.4TIONSA'EHICLMISPEC'IAL ITEMS RE; UTILITY DEPARTMENT SEE BACK OF CERTIFICATE FOR CLASS COVERAGE AND OWNERSHIP COVERAGE DETAIL 712880 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE. CITY OF FORT COLLINS EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDFAVOR TO MAIL ATTN: UTILITY DEPARTMENT _ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 700 WOOD ST. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR FORT COLLINS CO 80522 LIABILITY OF ANY HIND UPON THE COMPANY ITS AGENTS OR REPRESENTATIVE AUTHORIZED REPRESENTATIVE Rodney Postillion ARCLSASN CSRSgfxm IIB'221012' 14:47 xMMII UIrttW 12,15 IYW 12 INI:MI TM-155 CERTIFICATE HOLDER COPY CITY OF FORT COLLINS ATTN: UTILITY DEPARTMENT 700 WOOD ST. FORT COLLINS CO 80522 POLICY NUMBER: 4068533 BUSINESS LOCATION: G & J WAGNER ENTERPRISES INC CLASSIFICATION OF OPERATION CLASS DESCRIPTION COVERAGE COVERAGE RATING EFFECTIVE EXPIRES TYPE 621705 EXCAVATION N.O.C. 05/01/2003 05/01/2004 EM Commercial Certificate of Insurance FARMERS Agency . Jim Beemer Agency Name . 2705 W loth Street Issue Date (MM/DD/1]� & • Greeley, CO 80634 08/22/2003 Address 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 St 07 Dist. 04 Agent 356 coverage afforded by the policies shown below. Companies Providing Coverage: Insured Company A Truck Insurance Exchange GBcJ Wagner Enterprises, Inc. Letter Name .Wagner Lawn Care i� pany B Farmers Insurance Exchange & • PO Box 397 company C Mid -Century Insurance Company Address • Red Feather Lakes, CO 80545-0397 Letter Company Letter Coverages This is to certify that 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. Limits shown may have been reduced by paid claims. Co. Ltr. T of Insurance Poli Number L7 Policy Eifective Date (mtavonml Policy Expiration Date (nand" Policy Limits cY p X General Liability 045903234 5/5/03 5/5/04 General Aggregate $1000 >000 Commercial General Products-Comp/OPS Aggregate $ 1,000,000 Liability Personal & - Occurrence Version Advertising Injury $ 1,000,000 Contractual - Incidental Each Occurrence $ 1,Of10,o00 014 Fire Damage (Arty one fire) $ 100,000 Owners & Contractors Prot. Medical Expense (Anyone person] $ 5,000 A Automobile LiabilityCombined Single All Owned Commercial Limit $ 1,000,000 Autos Bodily Injury y '\ Autos 045903234 6/17/03 5/5/04 ]Per person) $ HireScheduled utos Bodily In (Per acydden� $ Non -Owned Autos Garage Liability Property Damage $ Garage Aggregate $ Umbrella Liability Limit $ Workers' Compensation statutory and Each Accident $ Employers' Liabllli y Disease - Each Employee Disease - Policy Limit $ $ Description of Operations/Vehicles/Restrictions/Special items: City of Fort Collins -Utility Department is an additional insured as their interests may appear. Certificate Holder Cancellation . City of Fort Collins Should any of the above described policies be cancelled before the expiration date Name . Utility Department thereof, the issuing company will endeavor to mail 30 days written notice to the & • 700 Wood Street certificate holder named to the left, but failure to mail such notice shall impose no Address • Fort Collins, CO 80522 obligation or liability of any kind upon the company, its agents or representatives. c A Representative es-2492 4-94 Copy Distribution: Service Center Copy and Agent's Copy a-m