HomeMy WebLinkAboutABC MERIT SHOP AUI - INSURANCE CERTIFICATEACORD.
DA12/09/03
PRODUCER
ATon Services, Inc. of New Mexico
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
6000 Uptown Blvd NE
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
Suite 400
Albuquerque NM 87110 USA
CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
PHoNE• 505 889-6700 FAX- 505 884-7831
INSURED
INSURER A: Midwest Employers Cas. Co.
ABC Merit Shop WC Fund
AUI Inc.
INSURERB:
INSURER C:
P.O. Box 9825
Albuquerque NM $7119-9825 USA
INSURER D:
INSURER E:
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.
LTR
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY E
DATB(MMOMYY)
POLICY EXPIRATION
DATE(MMADD\YY)
'
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
FIRE DAMAGE(Am ow fie)
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE ❑ OCCUR
MED EXP (Any ow p n)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
GENT. AGGREGATE LIMIT APPLIES PER:
POLICY 0 �PR0.• LOC
PRODUCTS-COMP/OP AGO
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
ANY AUTO
(Ea acoident)
BODILY INJURY
ALL OWNED AUTOS
SCHEDULED AUTOS
( Per peteon)
BODILY INJURY
HIRED AUTOS
NON OWNED AUTOS
(Per accdenq
PROPERTY DAMAGE
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
ANY AUTO
OTHER THAN EA ACC
AUTO ONLY:
AGG
EXCESS LIABILITY
EACH OCCURRENCE
OCCUR ❑ CLAIMS MADE
AGGREGATE
DEDUCTIBLE
RETENTION
A
WORKERS COMPENSATION AND
EMPLOYERS'LIABIITY
EW0005487
SIR Deductible $350,000
12/31/03
12/31/04
X
we STATU-
CRY LIMITS
oTTL-
&L. EACH ACCIDENT
$1,000,000
E.L. DISEASE -POLICY LIMIT
$1,000,000
EL. DISEASE -EA EMPLOYEE
$1,000,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL. PROVISIONS
RE: Pipe Bursting Project
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
Cl ty Of Fort CQ I I l ns DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Purchasing Division 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
215 N . Mtson Street BUT FAILURE TO DO SO SHALL RAPOSE NO OBLIGATION OR LIABILITY
Fort Col l ins CO 80522 USA OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Certificate No : 570008076786 Holder Identifier :