HomeMy WebLinkAboutWESTRIAN GROUP JR ENGINEERING SUNSTONE RESOURCES - INSURANCE CERTIFICATEACORD. CERTIFICATE OF LIABILITY INSURANCE DATE
09-22-2004
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
VAN GILDER AGCY CO/A&E PRGM/PHS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
343366 P: (866)467-8730 F: (877) 905-0457 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P . 0. BOX 33015 INSURERS AFFORDING COVERAGE
SAN ANTONIO TX 78265
INSURED INSURERA:Hartford Accident & Indemnitv Co
WESTRIAN GROUP, INC.; JR ENGINEERING, INSURER B:
LLC; SUNSTONE RESOURCES, LLC INSURER Ct
6050 GREENWOOD PLAZA BLVD INSURER D:
ENGLEWOOD CO 80111 INSURERE:
rnVFRArFc
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.
NOR
LTR
TYPE OF INSURANCE
POLICY NUMBER POLK:Y EFFECTIVE
DATE MM/DDlYY
POLICY EXPIMTION LIMA
DATE MMIDDIYY
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE u OCCUR
EACH OCCURRENCE 8
FIRE DAMAGE (Any one lira) 8
MED EXP (Any one person) 8
PERSONAL & ADV INJURY 8
GENERAL AGGREGATE 8
GENT AGGREGATE LIMIT APPLIES PER:
POLICY ^ PRO LOC
JE
PRODUCTS - COMP/OP AGG
8
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
COMBINED SINGLE LIMIT
(Ea accidentrt)
8
BODILY INJURY
(Per Person)
8
BODILY INJURY
(Per accident)
8
PROPERTY DAMAGE
(Per accident)
8
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
8
OTHER THAN EA ACC
AUTO ONLY: AGG
$
8
EXCESS LIASBJTY _
OCCUR u CLAIMS MADE
DEDUCTIBLE
RETENTION 8
EACH OCCURRENCE
8
AGGREGATE
8
8
8
8
A
WORKERS COMPENSATION AND
EMPLOYER` UABRM
34 WEG KD8169
10/01/04
10/01/05
TATUTH-
WC SLIMIT X DER
E.L. EACH ACCIDENT
81, 000, 000
E.L. DISEASE - EA EMPLOYEE
T 1, 0 0 0, 0 0 0
E.L. DISEASE - POLICY LIMIT
81 , 0 0 0 , 0 0 0
OTHER
DESCRIPTION OF OPEMTIONS/LOCATIONSIVENK:LES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Those usual to the Insured's Operations.
CIFRTIRCATF Mn1 nFR I CANCFI 1 ATInN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City
of Fort
Collins
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
45 DAYS WRITTEN NOTICE 00 DAYS FOR NON-PAYMENT) TO THE CERTIFICATE
Attn • James
P 0 BOX 580
O'Neill, CPPO
HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO
OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
Fort
Collins,
CO 80522
`AUTHORIZED REPRESENT Ea
•�.��Y�LO.�eRA�
ACURD Zs-5 17/97) 0 ACORD CORPORATION 1988