HomeMy WebLinkAbout129302 HAGEMAN EARTH CYCLE - INSURANCE CERTIFICATE (13)DATE
ACORDTM CERTIFICATE OF LIABILITY INSURANCE 10117103Dnvrrl
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood 8 Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
4821 Wheaton Drive I ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P O Box 270370
Fort Collins, CO 80527
Hageman Earth Cycle, Inc.
Hageman Enterprises, LLC
3501 1/2 E. Prospect Street
Fort Collins, CO 80525
INSURERS AFFORDING COVERAGE
INSURERA: Continental Western G
INSURER B:
INSURER C:
INSURER D:
INSURER E:
NAIC #
I WVQR W&C
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.
Sit
LTR
I%DD'L
INSR1
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MhV-
POLICY XPIRATION
DATE MMIDD/YV
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CWP2344893
09/01/03
09/01/04
EACH OCCURRENCE
$1 000000
TO
PREMI ES(Ea occurrence)RENTED
$1OO DUD
MED EXP (Any one person)
$5 000
CLAIMS MADE 5� OCCUR
PERSONAL & ADV INJURY
$1 00U 000
X PD Ded:500
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$2 00O 000
POLICY PRO- 7 LOC
JECT
A
AUTOMOBILE
LIABILITY
ANY AUTO
CWP2344893
09/01/03
09/01/04
COMBINED SINGLE LIMIT
(Ea accident)
$1r UUU,UUU
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
A
EXCESS/UMBRELLA LIABILITY
CWP2344893
09/01/03
09/01/04
EACH OCCURRENCE
$1 00U 000
AGGREGATE
$1 00O 000
X OCCUR CLAIMS MADE
$
$
RDEDUCTIBLE
$
X RETENTION $ 10000
WC STATU- OTH•
WORKERS COMPENSATION AND
E.L. EACH ACCIDENT
$
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
E.L. DISEASE - EA EMPLOYE
$
E.L. DISEASE . POLICY LIMIT
$
If yes, describe under
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I 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 _In 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 INSURER, ITS AGENTS OR
AUTHORIZED
ACORD 25 (2001108) 1 #M262397 II ACORD CORPORATION 191