HomeMy WebLinkAboutROY EDWARDS E P TRUCKING - INSURANCE CERTIFICATE (2)CERTIFICATE OF INSURANCE
{TAIF FARM
T Is ® STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois
❑ STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois
in uX,�, I ng policyholder for the coverages Indicated below. r n "
" of policyholder ROY EDWARDS .OF— Cr {�
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Address of policyholder 5809 S COUNTY RD 7
FORT COLLINS, CO 80528
Location of operations 5809 S COUNTY RD 7
Description of operations DUMP TRUCK SERVICES
The policies listed below have been Issued to the policyholder for the policy periods shown. The Insurance described in these policies
suhiact to all the terms exclusions. and conditions of thnsa nnlicias. The limits of Nahllhv shnwn may have been rMIUmd by anv nsid rlaima
POLICY NUMBER
TYPE OF INSURANCE
POLICY PERIOD
LIMITS OF LIABILITY
Effective Data Ex iration Date
at beginning of policy period)
Comprehensive
BODILY INJURY AND
Business Liability
PROPERTY DAMAGE
This insurance includes: ❑ Products - Completed Operations
❑ Contractual Liability
❑ Underground Hazard Coverage
Each Occurrence S
❑ Personal Injury
❑ Advertising Injury
General Aggregate $
❑ Explosion Hazard Coverage
Products - Completed
❑ Collapse Hazard Coverage
Operations Aggregate $
❑ General Aggregate Limit applies to each project
El
El
EXCESS LIABILITY
POLICY PERIOD
BODILY INJURY AND PROPERTY DAMAGE
Effective Data Expiration Date
(Combined Single Umrl)
❑ Umbrella
Each Occurrence $
El Other
Aggregate
Part f 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 Data Expiration Date
LIMITS OF LIABILITY
at beginning of policy "riod)
01 2121- -0
86 KENWORTH1
31
L 0
Name and Address of Certificate Holder
CITY OF FORT COLLINS
PURCHASING DEPARTMENT
FORT COLLINSe CO
55a-994 a 2.90 Printed In U.S.A.
a'd b860622DL6
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 3 0 days before cancellation. If,
however, we fail to mail such notice, no obligation or liability
will be imposed on State Farm or its agents or
representatives.
Data
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