HomeMy WebLinkAboutSTEPHEN SHIPP PLUMBING HEATING - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE
American Family Insurance Company ❑
American Family Mutual Insurance Company if selection box is not checked.
6000 American Pky Madison, Wisconsin 53783-0001
Insured's Name and Address Agent's Name, Address and Phone Number (Agt./Dist.)
Stephen Shipp Plumbing & Heating Kathy A. Collins (970) 225-6866
Stephen M Shipp 1119 W Drake Rd Ste C-28
1321 Saint John PI Fort Collins, CO 80526-2476 (139/309)
Fort Collins, CO 80525-8806
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 covers" afforded by the policies listed below.
This is to certify that policies of insurance gated below have been issued to the Insured named above for the policy pencil 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.
TYPE OF INSURANCE
POLICY NUMBER
POLICY DATE
LIMBS OF LIABILITY
EFFECTIVE EXPIRATION
(Mo. Day, Yr Mo Day, Yr
Homeowners/
Bodily Injury and Property Damage
Mobilehomeowners Liability
Each Occurrence $ 000
Boatowners Liability
Bodily Injury and Property Damage
Each Occurrence $ ,000
Personal Umbrella Liability
Bodily Injury and Property Damage
Each Occurrence $ ,000
Farm/Ranch Liability
Fan Liability & Personal Liability
Each Occurrence $ 000
Farm Employer's Liability
Each Occurrence $ 000
Workers Compensation and
Statutory • :f�•it:r
Each Accident $ .000
Employers Liability t
Disease - Each Employee $ ,000
Disease - Policy Limit $ ,000
General Liability
General Aggregate $ 1,000 01O
Products - Completed Operations A r to $ 1,000 ,000
® Commercial General
Liability (occurrence)
❑
05-XE1059-01-00
10/08/2003
10/08/2004
Personal and Advertising Injury$ 500
Each Occurrence $ 500,000
Damage to Premises Rented to You $ 100 000
Medical Expense (Any One Person) $ 5 000
Businessowners Liability
Each Occurrencet t $ '000
Aggragalett $ ,ow
Liquor Liability
Common Cause Limit $ .000
Aggregate Limit $ ,000
Automobile Liability
❑ Any Auto
❑ All Owned Autos
Bodily Injury - Each Person $ 000
Bodily Injury - Each Accident $ ,000
❑ Scheduled Autos
❑ Hired Auto
Property Damage $ 000
Bodily Injury and Property Damage Combined $ ,000
❑❑ NOnowned Autos
Excess Liability
❑ Commercial Blanket Excess
EachOccurtenca/Aggregate $ 000
Other (Miscellaneous Coveraaesl
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / RESTRICTIONS / SPECIAL ITEMS t The individual or partners shown as insured ❑ Have ❑ Have not
Plumbing and Heating elected to be ocvered as employees under this policy.
t t Products -Completed Operations aggregate Is equal to each
occurrence limit and is included in policy aggregate.
GEii7iFICA7EI10LI3Ep'SNAME`AN4ApDRESS - - .. ..:
J CANCEU,' TION
• City of Fort Collins
tY
PO Box 580
Fort Collins, CO 80522
Should any of the above described policies be cancelled before the
expiration date thereof, the company will endeavor to mail •( days)
written notice to the Certificate Holder named, but failure to mail such
notice shall impose no obligation or liability of any kind upon the
company, its a ents or representatives. '10 days unless different
number of days shown.
® This certifies coverage on the date of issue only. The above
described policies are subject to cancellation in conformity with their
terms and by the laws of the state of issue.
DATE IS UED
10/14/2003
SENTATIVE
L
U-201 Ed. 5/00 Certificate Holder llz�-c / Stock No. 06668 Rev. 7/02