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Home My WebLink AboutHEIMBUCK DISPOSAL - INSURANCE CERTIFICATE (8)ACMCERTIFICATE OF LIABILITY INSURANCE DATE (MMrowww)07/22/2003 PDXWOR (308 635-2023 FAX (309)632-7359 J. G. Elliott Company 1111 East 20th Street P 0 Box 1643 Scottsbluff, NE 69363-1649 THO GERT1114CATIE IS ISSUED MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC A Now= "*I ck Disposal,Inc. P 0 Box 270310 Ft. Collins, CO 60527 INSuRERA: 2 rich American Ins Co INSURER B: INSURERC: INSURER D: 'AV INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE NSU D NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT, 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 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF SIBURANCB POLICY NUMBER MWASAW 79912W LOWS GENERAL LWNLIIY GLO491642400 07/16/2003 07 16/2004 EACH OCCURRENCE s 1 000 1 ON DAMAGr I u RERrEff— (Elk 9MM06)S 100 ON X-1 COMMERCIAL GENERAL LIABILITY CLAIMS MADE [y] OCCUR -PREMISES MED EXP (Any any pe w ) S 5 A PERSONAL& ADV INJURY $ 1 0oD GENERAL AGGREGATE $ 2 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS- COMP70P AGO S 2,000,00( POLICY J LOC AUTOMOBILE LuuLITY X ANY AUTO BAP491642600 07/16/2003 07/16/2004 COMBINEDOSINGLE UNIT $ 1 000 INJURY (P�r Lp� ) $ A ALL OWNEDAUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS _ BODILYINJURY _, S PROPERTY DAMAGE (PW &edd*nq : GARAGE LWISJTY AUTO ONLY -EA ACCIDENT S ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGO S S ■ICESWULm1MLLA ILIABLTTY EACH OCCURRENCE S OCCUR CLAIMS MADE - AGGREGATE S s DEDUCTIBLE 5 RETENTION S $ WOMOM COMPENMTION AND EMPLOYERS' LMWTY WC491642700 07/16/2003 07/16/2004 TORY LIMITS ER E.L. EACH ACCIDENT _ s 500 A ANY PROPRIETORIPARTNERIEXECUTIV£ OFFICERIMEMBER EXCLUDED? If y� awaiM� undw SPECIAL PROAIONS bNow E.L. DISEASE - EA EMPLOYE S 500 E.L. DISEASE - POLICY LIMIT S Soo OTHM DNCWTM Of 111OLUSIO10— ADM BY Mmm MIS certificate is provided inraccordance witht he above policy issued for the named insured. Limits shown may have been reduced by paid claims. City of Fort Collins Ed Sonn•tte, Purchasing Division PO Box S80 Fort Collins, CO 60522 CANCEU.BD MMRE THE aXPmAT10N DATE YMPO P. THm IM.IMIG SHSUIIBI WILL ENDEAVOR TO AWL —11_ DAYS wRn mi NOTICE TO THE corrrHCATE HOLDER NAMED TO TTm LEFT, BUT FARANE TO MAIL SUCH NOTICE •TALL HMPOSE NO OBLIGATION OR LIABLITY OF ANY IOND UPON THE BISURK ITS AQWQM, OR AWRO INTATMER INORQBD REPIMBEMATFM = W,wm*-1VTN1 ACORD 26 (2001108) FAX: GACORD CORPORATION 1Bas `ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MWDD/YYYY) 07/22/2003 1. G. Elliott Company 1111 East 20th Street P 0 Box 1648 Scottsbluff, NE 69363-1648 INSURED Heimbuck Disposal, In P 0 Box 270310 Ft. Collins, CO 80527 ONLY AND CONFERS N( HOLDER. THIS CERTIFIC ALTER THE COVERAGE INSURERS AFFORDING COVERAGE INSURERA: Zurich American Ins INSURER B: INSURER C: INSURER D: INSURER E: ION THE CERTIFICATE (OT AMEND, EXTEND OR BY THE POLICIES BELOW. NAIC # 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. 'MSRDDJLTR NS TYPE OF INSURANCE POLICY NUMBER DATE MMIDD FFECTIVE I POLICY EXPIRATION DATE MMID LIMITS GENERAL LABILITY GL0491642400 07/16/2003 07/16/2004 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurance $ 100,000 X COMMERCIAL GENERAL LIABILITY MED EXP (Any one Person) $ 5,000 CLAIMS MADE M OCCUR A PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS- COMPIOP AGG $ 2,000,000 FJ POLICY JERcT LOC AUTOMOBILE LIABILITY ANY AUTO RAP491642600 07/16/2003 07/16/2004 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per Person) $ A ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHERTHAN EA ACC $ ANY AUTO AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ❑ CLAIMSMADE AGGREGATE $ $ DEDUCTIBLE $ $ RETENTION $ WORKERS COMPENSATION AND WC491642700 07/16/2003 07/16/2004 TORY LIMITS I I ER A EMPLOYERS LIABILITY ANYPROPRIETORIIEXECUTIVE EXCLUDE OFFICERIMEMBER EXCLUDED? E.L. EACH ACCIDENT $ 500OO E.L. DISEASE -EA EMPLOYEE $ 500,000 If yea, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ 500,00 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS his 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 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL City of Fort Collins _l0 DAYS WRrrTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Ed Bonnette, Purchasing Division BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LABILITY PO Box 580 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORQED REPRESENTATIVE Fort Collins, CO 80522 Kim Hurst KIM ACORD 25 (2001108) FAX: (970)221-6707 ®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), authori2nd 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. '%L'URU L7 tLYY7/U8)