HomeMy WebLinkAboutARMADILLO FENCE - INSURANCE CERTIFICATE (2)03252005 09:52 970-229-9087 Larry D Peterson Agency Page 22
CERTIFICATE OF LIABILITY INSURANCE
American Family Insurance Company ❑
American Family Mutual Insurance Company if selection box is not checked.
6000 American Pky Madison, Wisconsin 53783-0001
Agent's Name, Address and Phone Number (Agt./Dist.) Insured's Name and Address:
Larry D Peterson (1191309) Armadillo Fence and Security
149 W Harvard, Suite102 229 N Hwy 287
Fort Collins, CO 80525 Fort Collins, CO 80524
970-229-9393
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 afforded by the ooliCies listed below.
CO"Ri4G83
This is to certify that policies of insurance listed below have been issued to the insured named above for the policy period indicated, notwithstanding any
requirement, tens 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.
POLICY TYPE
Effective
Expiration
TYPE OF INSURANCE
POLICY NUMBER
LIMITS OF LIABILITY
Mo,Da ,Yr
Mo,Da ,Yr)
Homeowners/
Bodily Injury and Property Damage
Mobllehomeowners Liability
Each Occurrence
Boatowners Liability
Bodily Injury and Property Damage
Each Occurrence
Personal Umbrella Liability
Bodily Injury and Property Damage
Each Occurrence
Farm/Ranch Liability
Farm & Personal Liability Each Occurrence
Farm Employers Liability Each Occurrence
Statutory
Workers Compensation and
Each Accident
Employers Liability +
Disease - Each Employee
Disease -Polic Limit
General Liability
05-XF9663
5212004
5212005
General Aggregate $ 2,000,000
® Commercial General
Products - Completed Operations Aggregate $ 2,000,000
Liability (occurrence)
Personal and Advertising Injury $ 1,000,000
❑
Each Occurrence $ 1,000,000
❑
Fire Damage (Any One Fire) $ 100,000
Medical Expense (Any One Person) $ 5,000
Businessowners Liability
Each Occurrence + +
Aqqregate + +
Automobile Liability
05-XF9663
5212004
5212005
Bodily Injury- Each Person 1,000,000
x Owned Autos (Basic form)
Bodily Injury - Each Accident 1,000,000
❑ Owned Autos (Comp form)
Property Damage 250,000
❑ Hired Autos
Bodily Injury & Property Damage Combined
❑ Non -owned Autos
❑ Garage liability
Excess Liability
❑ Commercial Blanket Excess
05-XF9663
5212004
5212005
Each Occurrence/Aggregate 1,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS
+The individual or partners shown as Insured *" elected to be covered
Project Name: The Gardens
as employees under this policy.
Coverage exists for materials stored in a temporary location up to $50,000.
++ Products -Completed Operations aggregate is equal to each
occurrence limit and is included in policy aggregate.
CERTIFICATE HOLDER'$ NAME AND ADDRESS
CANCELLATION
El Should any of the above described policies be canceled before the
City
City of Fort Collins
expiration date thereof, the company will endeavor to mail'( 10 days) written
Attn: John Stephen
PO Box John
notice to the Certificate Holder named, but failure to mail such notice shall
Fort Collins, CO 80522
impose no obligation or liability of any kind upon the company, its agents or
representatives. `10 days unless different number of days shown.
❑ This certifies coverage on the date of issue only. The above described
policies are subject to cancellation in conformity with their terms and by the
laws of the state of issue.
DATE ISSUED
AUTHORIZED REPRESENTATIVE
3-25-05-v_
r.}
U-201 Ed. 1196 ORIGINAL - Certificate Holder, COPIES to Services, Insured, Agent Stock No. 06668