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Home My WebLink AboutMATT IVERSON MSI ENTERPRISES - INSURANCE CERTIFICATE04-12-2006 10:32 9703510616 PAGE:2 ACORD N CERTIFICATE OF LIABILITY INSURANCE DATEIMM/DD/YYM 4/12/2006 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 827 llth By Suite A HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Greeley, Co 80631 INSURERS AFFORDING COVERAGE I INSURER A. Atlantia Casualty Inauranaa Company NAICM INSURED MATT IVERSON DHA _ MSI ENTERPRISES, INC. ' INSUKEK B 2431 N SHIELDS ST MEC: FORT COLLINS, CO 80524 INSURCR DD 970-217-9975 INSURER E. 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 OMEN DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED I IEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ALTAR `NBRa TYPF nr INCI IRANr.F POLICY NUMBER DATE MMtDED TY E POLICY EXPIRATION LIMITS GENERAL LIABILITY j I j MAIMSMADF. I X j OCCUR A�I— GEN'L AGGKtGAIt LIMIT APPLIES Ptl X POLICY �I JET I LOC AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS _ SCHEUULEDAUTUS HIRED AUTOS NUN-OWNLUAUIOS ANYALITO FXCFSVUMBREt.LA LIABILITY _' OCCUR LI CLAIMSMAUL HDEDUCTIBLE RETENTION $ WORXPRS COMPENSATION AND EMPLOYERS' LIABILITY My VH0FV1ET0PX1AATNF(1FXFMRIW OFFICERMILWILK LXCLULXAP EACH OCCURRENCE. $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea oa w.m.$) $ 100,000 MEU ExP tanv one pereanl $ 5,000 04/11/06 04/11/07 PERSONAL &ADV INJURY $ 1,000,000 GENFRAL AGGREGATE. S 1,000,000 PRODUCTS - COMP/DPAGG $ 1,000,000' C#.,4-, s / ,S'C 41J Y /S 40 /N ro S) /M- AJ Gor�'s f D� 10�,✓� � � I TFSCkIPTION OF OPERATIONS I LOCATIONS [VEHICLES / EXCLUSIONS ADDED BY Excavation Additional Insured Attention: Ed Bonnette City of Fort Collins PO BOX 580 Ft Collins, CO 80522-0580 FAX: 970-221-6707 COMRINFD SINGI F 1 AMR S I&a idalrt) UOUILYINJUNY $ (Per perem) BODILYINJUKY $ IPerxccXlenU PROPERTY DAMAGE $ IPeraccmme AUTO ONLY-EAAGCIOFNT S OTHERTIIMI EAACC S AUTOONLY. ACG $ EACH OCCURRENCE $ A0GkEGA1C Is E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYE S_ C.L. DISEASE - POLICY LIMIT $ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE TI IEREOr, THE ISSUING INSURFR WILL ENDEAVOR TO MAIL 1 O DAYS WRIT TEN NOTICF TO TI IE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OFANIY KIND UPON THF. INSURER, ITS AGENTS OR AUTHORIZED ACORD25(2001108) WAGORD CORPORATION 1933 04-12-2006 10:32 9703510616 PAGE:1 From the office of - Security Insurance Group 6310 W 10"' St Greeley, CO 80634 DATE: To: f d�wG SUBJECT M SL,f'''`� � - O �h f fewv. lL Page 1 of CZ 04-12-2006 10:32 9703510616 PAGaE:2 QATE(MMIDWYYYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE 4/12/2006 PRODUCER THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 027 llth Sy Suite A ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Greeley, Co 80631 INSURERS AFFORDING COVERAGE NAICS INSURED MATT IVERSON DBA I INSURER A' Atlantic Caavalty Iaauraacn C=PIWiy MSI ENTERPRISES, INC. INSURER B 2431 N SHIELDS ST INSURER C: FORT COLLINS, CO 80524 INSURER D: 970-217-9975 INSUKER E: LrU V tnAuca THE POLICIES OF INSURANCE LISYEO BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACI ON 01 HER DOCUMENT WITH RESPECT TO WHICH IHIS CILK I IF ICA It MAY HE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED I IEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. tlYBR o POLICY NUMBER DATE MMfD m DATE MM EXPIRATION LIMBS LTR NSRD TYPEFINSURANCE R EACH OCCURRENCE. 8 1 O00 , 000 GENERAL LIABILITY , DAMAGE TO RENTED ; 100,000 X COMMERCIAL GENERAL LIABILITY _PREMISES ([a ycwvk") CIAIMSMAOF •• I OCCUR MEULXP(Anyo wN ) S 5,000 Arenwal 04/11/06 04/11/07 PERSONAL&ADVINJURY $ 1,000,000 I GFNFRAL AGGREGATE $ _ 1,000,000 GEN'L ACGREGAIt LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S 1,000100 0 X POLICY PRO- LOC JECT AUTOMOBILE LIABILITY COMRINFD SINGI F I IMIT $ (Ee ecgident) ANYAIITD ALL OWNED AUTOS BOUILY INJURY $ IPaf p6feal) _ SCHEUULEUAUTOS HIRED AUTOS BODILY INJURY $ IYarecc+denq NON-OWNLUAU 1 US PROPERTY DAMAGE $ (ParaccWenU GARAGE LIABILITY AUTO ONLY -EA ACCIOFNT S ANYALTfO OTHCRTIIAN EAACC 3 3 AUTOONLY. AGG FXCFSSIUMBRELLA LIABILITY EACH OCCURRENCE $ AGCkECAIE S OCCUR L CLAWSMAUE $ _ _ $ DEDUCTIBLE 3 RF.TF.NTION S WORKFRSCOMPENSATION AND -_-, TORYLIMITS ER EMPLOYCRS' LIABILITY E.L. EACH ACCIDENT 3 ANY PROPRiET*"pAnTNFIWXFCIITIVF WFICS"LM I-M L%6LVVtw -'-"-" E.L. DISEASE - EA EMPLOYEI 3_ Ilyae, dawl6aur10ef E.L. DISEASE -POLICY LIMIT $ SPEC IAL PROVISIONS Delm OTHER UhSCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENUOKStMEN'I I SPECIAL PHOVISIONS Excavation Additional Insured Attention: Ed Bonnette City of Fort Collins PO Box 580 Ft Collins, CO 80522-0580 FAX. 970-221-6707 _ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATID DATE TI IEREOF, THE ISSUING INSURFR WILL ENDEAVOR TO MAIL 10 DAYS WRIT TEN NOTICF TO TI IC CERTIFICATE HOLDER NAMED TO TNF LCFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF_INY KIND UPON THF. INSURER, ITS AGENTS OR AUTHORIZED OACORD CORPORATION 1988 04-12-2006 10:32 9703510616 PAGE:1 From the office of: Security Insurance Group 6310 W 10`h St Greeley, CO 80634 FAX DATE: TO: SUBJECT: I►n _-- Page 1 of CZ