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Home My WebLink AboutARMADILLO FENCE - INSURANCE CERTIFICATE (3)03282005 09:31 970-229-9087 Larry D Peterson Agency CERTIFICATE OF LIABILITY INSURANCE American Family Insurance Company ❑ American Family Mutual nsurance Company if selection box is not checked. 6000 AmerlCEn Pky Madison, Wisconsin 53783-0001 Agent's Name, Address and Phone Number (Agt./Dist.) Insured's Name and Address: Larry D Peterson (119/309) Armadillo Fence and Security 149 W Harvard, Suitii 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 dnas not amand axtand nr altar the rnvarana affnrdan by tha nnliriee liefnd halnw Page 22 COVERAGES 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, term or condition of any contract or other document wits 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, TYPE _POLICY Effective Expiration TYPE OF INSURANCE POLICY NUMBER LIMITS OF LIABILITY (lvo,Da�,Y-) (Mo,Day,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 Employer's Liability Each Occurrence Statutory ... . Workers Compensation and Each Accident Employers Liability+ Disease- Each Employee Disease -Polic Limit General Liability 05-XF9663 5212)04 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 + + Aggregate + + Automobile Liability 05-XF9663 5212)04 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 502)04 521/2005 Each Occurrence/Aggregate 1.000,000 El 3 + The individual or partners shown as Insured "I elected to be covered as employees under this policy. C 0' ++ Products -Completed Operations aggregate is equal to each occurrence limit and is included in policy aggregate. CERTIACATE HOLDERS NAME AND ADDRESS CANCELLATION ❑ Should any of the above described policies be canceled before the City of Fort Collins Attn: Steve Seaseld expiration date thereof, the company will endeavor to mail'( 10 days) written PO Box 580 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-Lu r cu. rrao UICIUInAL - ceirmcate Holder, corps to services, Insured, Agent Stock No. 06668 03/28/2005 10:32 FAX 970 498 8917 ARMADILLO CONSTRUCTION 2 001 RMADILLO FEM&SK RM Armadillo Construction Company, Inc. 229 N. Highway 287 Fort CONins, Co 80524 Office: (970) 493-7887 Fax: (970)498-8917 F" COVER SHEET Date: Monday, March 28, 2005 From: Stan Grant Office Manager sarant0-armadillofence. com To: Carrie Peterson American Family Insurance 970-229-9393 Phone 970-229-9087 FAX Re: Insurance Certificates Pages Including this cover sheet: 1 I Carrie, I had you send the certificate of insurance for stored materials on Friday to John Stephen. Can you also FAX a copy to Steve Seefeld this AM? Below is his contact info... City of Fort Collins (The Gardens) - PO Box 580 Fort Collins, CO 80522 Attn. Steve Seefeld 970-221-6777 Phone 970-221-6534 FAX Stored amount = $381180 03282005 09:31 970-229-9087 Larry D Peterson Agency Page 12 Date: 03/28/2005 09:31 NO. OF PAGE: 2 (include this page) To: Name: Steve Seeseld Company: City of Fort Collins From: Name: Larry D Peterson Agency TEL & FAX: (TEL) 970-229-9393 (FAX) 970-229-9087 E-Mail : IF-eterso@amfam.com Company: American Family Insurance Comment: 03/31/2005 13:10 9702216534 FACILITIES 03)2812005 09:31 970-229-9087 Larry D Peterson Agency CERTIFICATE OF LIABILITY INSURANCE Amenctrn Family Insurance Company Q American Family Mutual nsurmco Company if selection box is not checked. 600o American PIQ, Nladison, Wisconsin 53783-0001 Agent's Name, Address and Phone Number (Agt./Dist.) insured's Name and Address: Larry 0 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 ktfomralion arlgr and confers no fights upon the Certificate Hollder. Thle.rerli irAm fine not amend. extend er alter the coveraoa of irded by the policies fisted below._. PAGE 01 Page 212 This is to cerft that policies of insurance listed below have been issued I.) the insured named above for the policy period indicated notwithstanding any requirement, tens or condition of any contract or other document wits respect to which this certificate may be issued or may pertain, the Insurance afforded by the ns p�qtcies described herein Is su ct to all the terms, exeluslons, and conditioof such policies. POLICY TYPE TYPE OF INSURANCE POLICY NUMBER LINNITS OF LIABILITY EBective Expiration (rvi ,4aLY-) (Mo,De ,Yr Homeowners/ Bodily Injury and Property Damage AAoblehomeowners Liability Each Occurrence Boatowners Liability Bodily Injury and Property Damage Each Occurrence Personal UmtNefla Liability Bodily Injury and Property Damage Each Occurrence Farm/Ranch Liability _ Farm & Personal Liability Each Occurrence Farm E to rs Liability Each Occurrence _ Statutory Workers Compensation and Each Accident Employers Liability+ Disease, Each Employee Disease - Policy Limit General Llabnty 05-XF9663 51212)04 5/21/2005 General Aggregate $ 2.000,000 El Commercial General Products - Completed Operations Aggregate $ 2,000,000 Liability (occurrence) Personal end Advertising Injury $ 1,000,000 ❑ Each Occurrence $1 000,000 ❑ Fire Damage (Any One Fire) $100,000 Medical Expense &I One Person $ 5,000 Businessawners Liobllty Each Occurrence + + A9gre to 4 + AutomobNo Liability 05-XF9063 521/2704 5/212005 Bodily Injury- Each Person 1.000,000 x Owned Autos (Basic fort) Bodily Injury - Each Accident 1.000.000 ❑ Owned Auto$ (Comp form) Property Damage 250.000 ❑ Hired Autos Bodily Injury & Property Damage Combined ❑ Norrawned Autos ❑ Garageliabilly ❑ _ Excess Liability ❑ Commercial Blanket Excess 05•XF9683 fi212J04 521/2005 Each Occurrence/Aggregate 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONSNENICLES/RESTRIC"IONEISF'ECIAL ITEMS erthis p shown as insured """ elected to be cove vtl under as e individual employees ea employees undarthls pokey. Project Name: The Gardens 1e t +Products -Completed Operations aggregate is equal M each Coverage exists for materials stored In a temporary location up t o S5C,000, occurrence Emit and is tncluded in policy aggregate. —_� tBRT J 11TOIOt.C#R'S NAME AND ADDRB83 y CANGLiUtTiON El Should any of the above described policies be canceled before the City of Fort Collins expiration dale thereof, the company will endeavor to mail "( 10 days) written Attn: Steve sesseld notice to the Certificate Holder named, but failure to mail such notice shaE PO Box San Impose no obligation or liability of any kind upon the company, Its agents of Fort Collins, CO $0522 representatives. *10 days unless different number of days shown . u 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 at the state of issue. DATE ISSUED 3-25-05 AUTHORIZED REEF`RESENTATIVE f .. I �� " .�._• U-201 Ed.1/96 ORIGINAL • Certificate Hadar, COPIES to Services, Insured, Agent Stock No. 06668