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HomeMy WebLinkAboutHEIMBUCK - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE OF ID B HEIMB-1 d DATE(MM/DD/YYYY) 10 14 04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Renaissance Insurance Group 631 Birch Street, Unit D HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Windsor CO 80550 Phone:970-674-8825 Fax:970-674-8826 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Allied Insurance Com an INSURER B: Employers Compensation Heimbuck Disposal, Inc. Tim Heimbuck INSURER C: INSURER D. PO BOX 270310 Fort Collins CO 80527 INSURER E: Cf1VFRAIMPR THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY PI DATE MM/DD/YY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE [K] OCCUR ACPMCT07501662675 11/01/05 11/01/06 EACH OCCURRENCE $ 1,000,000 PREMISES (Ea occurence) E 100,000 MED EXP (Any one person) s 5,000 PERSONAL & ADV INJURY E 1,000,000 GENERAL AGGREGATE s2,000,000 GENT AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC JECT PRODUCTS - COMP/OP AGO s2,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS ACPBA7501662675 11/01/05 11/01/06 COMBINED SINGLE OMIT (Ea accident) $1 000 000 r X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) S X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY- EA ACCIDENT E OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESSIUMBRELLA LIABILITY OCCUR F_ICLAIMS MADE DEDUCTIBLE RETENTION E EACH OCCURRENCE $ AGGREGATE $ E $ $ B WORKERS COMPENSATION AND EMPLOVERS'LUIBILITv ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? I/y es, describe under SPECIALPROVISIONSbeiow FN-329393-01 08/01/05 08/01/06 TORYLIMITS X ER E.L. EACH ACCIDENT s500000 E.L. DISEASE - EA EMPLOYEE s500000 E.L. DISEASE -POLICY LIMIT -- s500000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS This certificate is provided in accordance with the above policy issued for the named insured. Limits shown may have been reduced by paid claims. 2005NOV 3 Dry 1:38 CERTIFICATE HOLDER CANCELLATION CTYFTCO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL City of Fort Collins Linda IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR P.O. BOX 580 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Fort Collins CO 80522 IJay W. Helzer ACORD 25 (2001/08) ©kCORD b41(P=TION 1988