HomeMy WebLinkAboutC G S CO INC - INSURANCE CERTIFICATEACORD,M CERTIFICATE OF LIABILITY INSURANCE 09/18/ 03
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Guy Bliss Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
11684 N. Huron Ste. 4103 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Northglenn, CO 80234
303-450-2552 INSURERS AFFORDING COVERAGE NAIC#
INSURED C G & S CO. Inc INSURER A. Mid -Century Insurance CO
INSURERS Truck Insurance Exchange
2009 2nd Ave INSURER
Greeley, Co 80631 INSURER
CnT/FDAncs
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.
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OF
POLICY NUMBER
POLICY EFFECTIVE
DATE
POLICYEXPNUTWN
DATE
LIMITS
B
GENERAL LIABILITY
X COMMERCIALGENERALLIANUTY
CLAIMSMADE OCCUR
04597 88 56
09/21/03
09/21/04
EACH OCCURRENCE
$ r J 000
DAMAGE TO R T
PREMISES Fa occurence
$ 1 +
MEDECP(Any one person)
$ J000
PERSONAL & ADV INJURY
$1,00 O 0
J
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
PRO LOC
POLICY FRI
PRODUCTS-COMPIOPAGG
$ 2 , 0 J 0 0
B
AUTOMOBILE
LIABILITY
ANYAUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
Non-owNEDAUTos
O4597 88 56
0 9/2 1/03
09/21/04
COMBINED SINGLE LIMIT
(Ea accident)
S1,000,000
BODILY INJURY
(Perce�)
X
X
BODILY INJURY
(PeracadeM)
$
X
PROPERTY DAMAGE
(Pera ident)
$
GARAGE LIABILITY
ANYAUTO
AUTO ONLY -EA ACCIDENT
$
OTHER THAN EAACC
AUTOONLY: AGG
$
$
A
EXCESSIUMBRELLA LL48PUTY
X OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $ 10,000
0409 65 87
10/01/03
10/01/04
EACH OCCURRENCE
$1'0()0'000
AGGREGATE
$$ 2 + 0
$
$
$
A
OMMISC WEISATIONAND
T-
E111PLOYERS• LIABILITY
, Paovme AKTN ume
orsneaArtNaeR ora b?
ISPer
E IAL PROVISIONS below
0 4 0 9 65 87
10 / 01 / 01
10 / 01 / 0 3
X raxr WCSUMI oTR
TAXT ER
E L. EACH ACCIDENT
$1, 0 ,
E L. DISEASE - EA EMPLOYEE
E.L. DISEASE -POLICY LIMIT
1 $1, OJ 0
OTHER
DESCRIPTION OF OPERATTONSILOCATIONSIVEHICLESIEXCLUSIONSADDEDBYENDORSEMENTISPECIAL PROVISIONS
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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City Of Ft Collins DATE THEREOF, THE ISSUING INSURER Wn.L ENDEAVOR TO HAIL 30 GAYS WRITTEN
Po BOX 580 NOTICE TO THE CERTIFICATE HGLOM HAI ED TO TINT LEFT, BUT FAILURE TO 00 SO SHALL
Ft Collins CO 80522-0580 EIIPWANOOBLIGATIONORLIADILTTYOfANYIONDUPON THE INSURER,ITS AOEITSDR
Attn: Engineering Dept I Rom,