HomeMy WebLinkAbout129302 HAGEMAN EARTH CYCLE - INSURANCE CERTIFICATE (12)Clients- 24703
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ACORD- CERTIFICATE OF LIABILITY INSURANCE
DATE (MMID
11/29/04DNYYY)
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc
4821 Wheaton Drive
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P O Box 270370
Fort Collins, CO 80527
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
Hageman Earth Cycle, Inc.
Hageman Enterprises, LLC
3501 E. Prospect Street
Fort Collins, CO 80525
INSURERA: Continental Western Group
INSURER B:
INSURER C:
INSURER D:
INSURER E:
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.
INSIR
LTR
ADD'
NSR
TYPE OF INSURANCE
POLICY NUMBER
DATE (MMIDD/YYPOLICY E
POLICY
DATE MMIDD/VY EXPIRATION
LIMITS
A
GENERAL LIABILITY
CWP2344893
12/01/04
12/01/05
EACH OCCURRENCE
$1 OOOOOO
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
$1 OO OOO
CLAIMS MADE O OCCUR
MED EXP (Any one person)
$5 000
PERSONAL & ADV INJURY
$1 000 000
X PD Ded:500
GENERAL AGGREGATE
$2 00O 000
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
s2,000,000
1-1 POLICY PEA F I LOC
A
AUTOMOBILE
LIABILITY
ANY AUTO
CiWP2344893
12/01/04
12/01/05
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNEDAUTOS
_
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
EA ACC
$
ANY AUTO
$
AUTOONLY: AGG
A
EXCESS/UMBRELLA LIABILITY
CU2361408
12/01/04
12/01/05
EACH OCCURRENCE
$1 000 000
X OCCUR CLAIMS MADE
AGGREGATE
$1 000 000
$
DEDUCTIBLE
$
X RETENTION $10000
WORKERS COMPENSATION AND
WC STATU- OTH-
LIMITPR
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. DISEASE - EA EMPLOYEE
S
OFFICER/MEMBER EXCLUDED?
If yes, describe under
E.L. DISEASE -POLICY LIMIT
S
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Re: Snow Removal
City of Fort Collins
Purchasing Department
256 W. Mountain Ave.
Fort Collins, CO 80521
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL AO_ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
AUTHORIZED
KIND UPON THE INSURER, ITS AGENTS OR
AVVRV AD tAUUI/UG) 1 of 2 #M300377 NIK 0 ACORD CORPORATION 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.
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