HomeMy WebLinkAbout235414 JUDGE NETTING - INSURANCE CERTIFICATESCF CENTRAL
of Insurance
VALLEY TEAM (602) 631-2900 10/23/03
insurance
Certificate Mailed To:
CITY OF FORT
P 0 BOX 580
FORT COLLINS
COLLINS
CO 80522-0580
Description of Operations:
Name of Insured:
JUDGE NETTING
23425 N 39 TH
SUITE 104-148
GLENDALE
Date Issued:
Certificate Number:
Policy Number:
Origin Date:
Expiration Date:
Liability
INC
DR STE
AZ 85310
10/23/2003
P0019
311881
11/02/2000
11/01/2004 12:01 A.M.
(000 Omitted) 1,000/1,000/1,000
FENCE CONST @ GOLF COURSE
"POLICY COVERS ONLY THOSE EMPLOYEES WHO WERE PHYSICALLY
HIRED IN AZ. FOR NO LONGER THAN 6 MOS IN ANOTHER STATE."
CANCELLATION CLAUSE
SHOULD THE ABOVE POLICY BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE
FUND WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE NAMED CERTIFICATE
HOLDER, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE FUND.
This Certificate is issued as a matter of information only and confers no rights upon the certificate holder.
This certificate does not amend, extend, or alter the coverage afforded by the policy listed hereon.
This is to certify a workers' compensation policy has been issued to the insured listed hereon and is in force
for the period referenced.
Certificate Issued To:
CITY OF FORT
P 0 BOX 580
FORT COLLINS
COLLINS Gre?Hermie
Authorized Representative
CO 80522-0580
61-004 02/27/03