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HomeMy WebLinkAboutKELLY UNDERGROUND - INSURANCE CERTIFICATEACORD. CERTIFICATE OF LIABILITY INSURANCE OP IDvB DATE (MWDOnrrY) 1 KEILEUN 08/03/05 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Truckers' Equity Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Mary L. Belleville HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 741090 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Arvada CO 80006-1090 Phone: 303-430-5725 Fax: 303-430-7698 INSURED INSURERS AFFORDING COVERAGE NAIC # INSO. ER A:_ Canal Insurance Company -- FI INSURER B: Atlantic Casualty Company LI: Keiley Underground 4 NSURER C—..— PO Box 689 INSURER D. Littleton CO 80160— ——— - INSURER E. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BECV ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CON TRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFLORDEJ 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. _— -.._.- r,.-.. -.___ .... POLICY.... INSR DD'L FFECTIYB POLICY EXPRUTION LTR NSRD TYPE PE OF INSURANCE POLICY NUMBER DATE )MMIDDryY) (M DATE (MMIDOITT) LIMITS GENERAL LIABILITY EACH OCCURRENCE ,000,000 $ X L109000022-1 09/24/04 09/24/05 DAMAGE TORENTED #�I:- COMMERCIAL GENERAL L.APILITY F EMSES(E.MX,Ye0M) ,000 CLAMS MADE X OCCUR ME➢EXP(My o, person) 5,000 j FPERSONAL S ACV INJURY 5 1, 000,000 ' GENERAL AGGREGATE f 1,000,000 — ( GEWL, AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOPAOG f 1,000,000 I PRO - II JECT LOD AUTO MOBILE LIABILITY -� COMBINED SINGLE LIMIT a1,000 , 000 A I ANY AUTO 475801 06J27/05 06/27 /06 (Ex a=dtlem) ALL OWNED AUTOS I X SCHEDULED Aui O: I BODILY INJURY f (PerpY'0n) HIRED AU105 BODILY INJURY t -_ NON OWNED AUTOS (Per 9altlenll PROPERTY DAMAGE t (PB,aWitlOnl) GARAGE LIABILITY AUTO ONLY -EA ACCIDENT 5 ANV AUTO _ _ 1 EA ACC t OTHER THAN EXCESSIUMBRELLA LIABILITY AUTO ONE Y: AGG S EACH OCCURRENCE S OCCUR __. -, CLAIMSMA0E AGGREGATE f— -- — IDEDUCTIBLE .I ... ... -. .... ... t r S RETENTION 5 I t T T WC OTH' WORKERS COMPENSATION AND LTATU- TORY LIMITS �ER EMPLOYERS' LIABILITY EL EACH ACCIDENT S AN V PROPRIETOWPARTNER.'EXECUTIVE --- 0 FICERIMEMBER EXCLUDED' E.L, DISEASE EAEMPL.YDE t SPECIAL PROVISIONS Cebw EL. DISEASE -POLICY LIMIT S OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER IS NAMED ADDITIONAL INSURED CERTIFICATE HOLDER CANCELLATION CITYOFF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF FT COLLINS DATE THEREOF, TIRE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN FAX 970-221-6378 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SNALL FAX 720-283-7260 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR PO BOX 580 FT COLLINS CO 80522-0580 REPRESENTAMES. AUTHORIZED REPRESENTATIVE K 25 (2001/08) ©ACORD CORPORATION 1988