HomeMy WebLinkAboutKIEWIT WESTERN CO - INSURANCE CERTIFICATE� � 4
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Producer 0271
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Midwest Agencies, Inc.
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.
3555 Farnam Street
THIS CERTIFICATE Doss BUT AMEND, EXTEND OR ALTER THE
Omaha, NE 6Str1
CDC AFFORDED BY THE POLICIES BELCAP.
CCMPANIES AFFORD
Company ZURICH AMERICAN INSURANCE COMPANY
A
Company STATE OF CALIFORNIA SELF -INSURED
Insured 0151001-JLB
B
KIEWIT WESTERN CO.
Company
7926 SOUTH PLATTE CANYON RD
LITTLETON, CO 80128
C
Company
D
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY
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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POLICY
POLICY
(30
LTR
TYPE OF INSURANCE
POLICY NUMBER
EFFECTIVE
DATE
EYPIRATION
DATE
LIMITS
GENERAL LIABILITY
General Aggregate
$
A
Commercial General Liab
GLO 4641069
07/15/04
03/01/07
Products -comp Cps Agg$
Claims Made mOccur
Personal & Adv Injury$00
Owner's & Cont Protective
Each Occurrence
$ 00
XCU
Fire Dama e(an 1 fire)
$ 000,000
Med ExD(anv oneperson)
(100
A
AUTOMOBILE LIABILITY
Any Auto
BAP 4641070
07/15/04
03/01/07
Combined Single Limit
$
All Owned Autos
Bodily Injury
Scheduled Autos
(per person)
$
Hired Autos
Non -Owned Autos
i/'h
/�\fly`_„
_
Bodily Injury
per accident)
$
roperty Damage
GARAGE LIABILITY
Auto Only - Ea Accident
$
Any Auto
JUL
n(1(yi
LUUT
Other Than Auto Only:�
........................................
Each Accident
$
Aggregate
EXCESS LIABILITY
�O
+a. () -
Each Occurrence
$
Umbrella .Form
C�TY OF
1SK MA
t�CibN1ENT
Aggregate
$
Other Than Umbrella Form
WORKERS' COMPENSATION AND
0
7'rStatutory Limi the
�: ��
A
EMPLOYERS' LIABILITY
WC 4641067
07/15/04
03/01/07
EL Each Accident
$....2
A
The Proprietor(,
Partners/Executive
Incl
C 4641068 (EXC)
07/15/04
03/01/07
EL Disease-PolicyLimit
$
Officers are:
Excl
/�y� y, C pT
Yc6t}�T C;7 (j,7
1.ni-90
EL Disease -Ea Employee
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
TIMBER II
TIMBERLINE ROAD EXTENSION, DRY CREEK CHANNEL IMPROVEMENTS
POUDRE RIVER TRAIL IMPROVEMENTS, PHASE II
03
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
B IRATION DATE THEREOF, THE ISSUING COMPANY WILL � MAIL
_DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
CITY OF FORT COLLINS
LEFT,
P.O. BOX 580
FORT COLLINS, CO 80522
Authorized Representat
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