HomeMy WebLinkAboutTHE BRENDLE GROUP - INSURANCE CERTIFICATECERTIFICATE OF INSURANCE
T 's< fiE9Nt t ® STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois
❑ STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois
❑ STATE FARM FIRE AND CASUALTY COMPANY, Scarborough, Ontario
INSURRNCED ❑ STATE FARM FLORIDA INSURANCE COMPANY, Winter Haven, Florida
❑ STATE FARM LLOYDS, Dallas, Texas
insures the following policyholder for the coverages indicated below:
Name of policyholder JUDITH DORSEY DBA THE BRENDLE GROUP INC
Address of policyholder 2138 SUNSTONE DR., FORT COLLINS, CO 80525
Location of operations SAME AS ABOVE
Description of operations BUSINESS OFFICE
The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is
subject to all the terms exclusions, and conditions of those policies. The limits of liability shown may have been reduced by any paid claims.
POLICY PERIOD
LIMITS OF LIABILITY
POLICY NUMBER
TYPE OF INSURANCE
Effective Date ; Expiration Date
(at beginning of policy period)
96-CW-8447-1
Comprehensive 12/03/04 12/03/05
BODILY INJURY AND
Business Liability
------------------=------------------
PROPERTY DAMAGE
-----------------------------
This insurance includes:
-----------------------------
❑ Products - Completed Operations
® Contractual Liability
❑ Underground Hazard Coverage
Each Occurrence $1, 000, 000
® Personal Injury
® Advertising Injury
General Aggregate $ 2, 000, 000
❑ Explosion Hazard Coverage
❑ Collapse Hazard Coverage
Products — Completed $
❑
Operations Aggregate
POLICY PERIOD
BODILY INJURY AND PROPERTY DAMAGE
EXCESS LIABILITY
Effective Date ExpNation Date
(Combined Single Limit)
❑ Umbrella
Each Occurrence $
❑ Other
Aggregate $
Part 1 STATUTORY
Part 2, BODILY INJURY
Workers' Compensation
and Employers Liability
Each Accident $
Disease Each Employee $
Disease - Policy Limit $
POLICY NUMBER
TYPE OF INSURANCE
POLICY PERIOD
Effective Date ; E)ira&m Date
LIMITS OF LIABILITY
(at beginning of policy period)
THE CERTIFICATE OF INSURANCE IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIRMATIVELY NOR NEGATIVELY
AMENDS, EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN.
If any of the described policies are canceled before
its expiration date, State Farm will try to mail a written
notice to the certificate holder 30
Name and Address of Certificate Holder days before cancellation. If however, we fail to mail
such notice, no obligation or liability will be imposed
City of Fort Collins on State F rm or its gents or representatives.
700 Wood Street
Fort Collins, CO 80522-0580
Sigiiature of thdF4K Representativ
Agent
Title Date
Agent's Code Stamp
AFO Code
558-994 a.3 04-1999 Printed in U.S.A. _