HomeMy WebLinkAboutHEIMBUCK DISPOSAL - INSURANCE CERTIFICATE (6)ACORD CERTIFICATE OF LIABILITY INSURANCE
TM.
E19 4'
7AUG
PRODUCER
DIVERSIFIED COMMERCIAL INSURERS
13693 E. ILIFF, STE. 225
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
AURORA CO 80014
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PHONE: 303-693-9343
FAX: 303-693-4351
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER A: Pinnacol
INSURER B:
TIM HEIMBUCK
DBA HEIMBUCK DISPOSAL, INC.
1925 TIMBERLINE RD. , STE 56
INSURER C:
INSURER D:
P.O. BOX 270310
INSURER E:
FORT COLLINS CO 80525
rnvFaer.Fc
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.
INSF
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MWDDIYY
POLICY EXPIRATION
DATE IMMIDDrfyl
LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
EACH OCCURRENCE
$
DAMAGE TO RENTED
PREMISES Me Q=n,%cel
$
MED. EXP (Any One Person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
GENT AGGREGATE LIMIT APPLIES PER:
POLICY
PRODUCTS-COMP/OP AGG.
$
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTYDAMAGE
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
EXCESS I UMBERELLA LUIBILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
S
$
$
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICERM6MSER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
4083464
JUL 21 04
AUG 1 05
TAJ-
TO YLIMIT OTHER
E.L. EACH ACCIDENT
$ 1DO,DDU
E.L. DISEASE -EA EMPLOYEE
$ 100,000
E.L. DISEASE -POLICY LIMIT
1 $ 500,000
OTHER:
DESCRIPTION OF OPERATIONS/LOCATION/VEHICLES/EXCLUSIONS ADDED ENDORSEMENT/ SPECIAL PROVISIONS
rFRTIFICATF Nni nFR I I ADDITIONAL INSURED: INSURER LETTER: rAAIroI I ATInki
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CITY OF FORT COLLINS
PURCHASING DIVISION
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10
DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
PO BOX 580
INSURER, ITS AGENTS OR REPRESENTATIVES,
FORT COLLINS, CO 80522
Attention:
AUTHORIZED REPRESENTATIVE
ACORD 25 (2001/08) Certificate # 12437 John Sentena RP100036426