HomeMy WebLinkAboutBARBARA KNAPPE SCOTCHIES CLEANERS - INSURANCE CERTIFICATE06/23/2004 14:57 FAX 8706694997 David Trumbc State Farm Q 002/003
STATE FA0.M CERTIFICATE OF INSURANCE
T is t STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois
❑ STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois
in ures+the�fall ing policyholder for the coverages indicated below:
of policyholder BARBARA KNAPPE DBA SCOTCHIES CLEANERS
Address of policyholder 1827 E MULBERRY ST
FORT COLLINS, CO 80524-3525
Location of operations SAME AS ABOVE
Description of operations
The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is
subject to all the terms exclusions, and conditions of those policies. The limits of liability shown may have been reduced by any Palo claims.
POLICY NUMBER
TYPE OF INSURANCE
POLICY PERIOD
LIMITS OF LIABILITY
Effective Date Expiration Date
at beginning of policy period
Comprehensive
BODILY INJURY AND
96-78-3680-8
Business Liability
08 01 02I
08 01 04
PROPERTY DAMAGE
This insurance includes: ® Products - Completed Operations
® Contractual Liability
® Underground Hazard Coverage
Each Occurrence $ 500 , 000
® Personal Injury
® Advertising Injury
General Aggregate $ 1, 000, 000
® Explosion Hazard Coverage
Products - Completed
® Collapse Hazard Coverage
Operations Aggregate $ 1, 000, 000
® General Aggregate Limit applies to each project
Li
El
EXCESS LIABILITY
POLICY PERIOD
BODILY INJURY AND PROPERTY DAMAGE
Effective Date Expiration Date
(Combined Single Limit)
❑ Umbrella
Each Occurrence $
❑ Other
Aggregate $
Part 1STATUTORY
Part 2 BODILY INJURY
96-GW-3572-5
Workers' Compensation
09/19/03
09/19/04
and Employers Liability
Each Accident S100, 000
Disease Each Employee $ 10 0 , 0 0 0
Disease - Policy Limit $ 50 0 0 0 0
POLICY NUMBER
TYPE OF INSURANCE
POLICY PERIOD
Effective Date Ex iration Date
LIMITS OF LIABILITY
at beginning of policy period)
96-78-3680-8
Bailees
0 01 03
08 01 4
60 000
653 0366-SO1
Comm Auto
D 01 4
1 OV01104
500,000
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 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.
Name and Address of Certificate Holder
City of Fort Collins
Administrative Services Purchasin
Division, Attn: Ed Bonnette
Fax 4221-6707
556.994 a 2-90 Printed in U.S.A.