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Home My WebLink AboutT J TRUCKING - INSURANCE CERTIFICATETilt .... . ..... PRODUCER THIS CERTIFICATE IS ISSUED AS A MAT -MR OF INFORMATION ONLY Pinnacol Assurance AND CONFEl.40 RIGHTS UPON THE CERTIFICATE HOLDER. THIS 7501 E Lowry Blvd , CERTIFICATE k OES NOT AMEND, EXTEND OR ALTER THE COVERAGE DENVER CO 80230-7006 AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE -�MPANY A Pinnacol Asmmce INSURED COMPANY T & I TRUCKING INC B 8739 NORTH TAFT HILL ROAD CCOMTANY FORT COLLINS CO 80524 C MPANY �QEk.......... THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM AND 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIN S. m TYPE OF INSURANCE POLICY NUMBER POLICY EFFECC T POLICY EXPIRATION LIMITS LTR DATE(aau4db,,,) DATEf��) GENERAL LIABILITY GENERAL AGGREGATE COMMERCIAL GENERAL LIABILITY PRODUCTS COMPIOF ACV CLAIMS MADE 11 OCCUR _PERSONAL @ ADV INJURY OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE FIRE DAMAGE LAW arc file) MED EXP (Amane AUTOMOBILE LIABILITY ANY ALTO COMBINED SINGLE LIMIT ALL OWNED AUTOS BODILY INTURY SCHEDULED AUTOS HIRER AUTOS BODILY INJURY NON OWNED AUTOS ddm) _Jg� PROPERTY DAMAGE GARAGE 1.1"111TY AUTO ONLY EA ACCIDENT ANY AUTO OTHER THAN AUTO ONLY. EACH ACIDENT AGGREGATE EXCESS LIABILITY EACH OCCURRENCE UMBRELLA FORM AGGREGATE OTHER T14AN UMBRELLA FORM WORKERS COMPENSATION AND WC STATU- OTNER X Li EMPLOYERS' LIABILITY TORY LIMITS A 4054162 03/01/2004 03/01/2005 EL EACH ACCIDENT_ THE PROPRIETORIPARTNBR& iNCL EL DISEASE POLICY LIMIT $500,000 EXECU T OFFICERS ARE MCL EL DISEASE BA EMPLOYEE $100,000 OTHER DESCRIPTION OF OPERAT]ONSILOCATTONSNEHICLESISPECIAL ITEMS SEE BACK OF CERTIFICATE FOR CLASS COVERAGE AND OWNERSHEP COVERAGE DETAIL 746707 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY OF FORT COLLINS EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ATTNAAMES B O'NIEL 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Po BOX 580 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR FORT COLLINS CO 80522-0522 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Kristin Trujillo Underwriter MOOREA CSR S%y [ 05IN/W WWU 154162 1211511M 12:W:W U%V135 CERTIFICATE HOLDER COY CITY OF FORT COLLINS ATTN: LAMES B O'NIEL PO BOX 580 FORT COLLINS CO 80522-0522 POLICY NUMBER: 4054162 BUSINESS LOCATION: T & J TRUCKING INC CLASSIFICATION OF OPERATION CLASS DESCRIPTION 722805 TRUCKING --LOCAL HAULING ONLY & DRIVERS COVERAGE COVERAGE RATING EFFECTIVE EXPIRES TYPE 03/01/2004 03/01/2005 EM