HomeMy WebLinkAbout128575 GRAY OIL COMPANY - INSURANCE CERTIFICATE (7)ACORD�
PRODUCER
INSURED
REVISED
FEDERATED MUTUAL INSURANCE COMPANY
5701 W. Talavi Boulevard
Glendale, AZ 85306
Phone: 1-888-333-4949
Home Office: Owatonna, MN 55060
GRAY OIL COMPANY INC
804 DENVER AVE
FORT LUPTON CO 80621
DATE (MMIDDIYY)
04/14/06
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 COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANY FEDERATED MUTUAL INSURANCE COMPANY OR
A FEDERATED SERVICE INSURANCE COMPANY
COMPANY
B
COMPANY
C
COMPANY
D
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 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO I
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION
LIMITS
LTR
DATE IMM/DD1YY)
DATE IMM/DD/YY)
GENERAL
LIABILITY
GENERAL AGGREGATE
5 2,00 000
X
PRODUCTS - COMP/OP AGG
$ 2,000,000
COMMERCIAL GENERAL LIABILITY
A
CLAIMS MADE Y OCCUR
9802287
03/01/06
03/01/07
PERSONAL & ADV INJURY
$ 1 000 000
EACH OCCURRENCE
$ 1,000,000
OWNER'S & CONTRACTOR'S PROT
FIRE DAMAGE (Any one fire)
$ 100,000
MED EXP (Any one person)
$
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
$ 1,000,000
X
ANY AUTO
BODILY INJURY
ALL OWNED AUTOS
A
SCHEDULED AUTOS
9802287
03/01/06
03/01/07
IPer person)
X
BODILY INJURY
8
HIRED AUTOS
X
NON -OWNED AUTOS
(Per accident)
PROPERTY DAMAGE
$
GARAGE
LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN AUTO ONLY:
9
EACH ACCIDENT
$
AGGREGATE
$
A
EXCESS LIABILITY
X UMBRELLA FORM
OTHER THAN UMBRELLA FORM
9802288
03/01/06
03/01/07
EACH OCCURRENCE
5 4,000,000
AGGREGATE
$ 4 000,000
9
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
THE PROPRIETOR/ INCL
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL
WC STATU- OTH
TORV LIMITS ER
EL EACH ACCIDENT
S
EL DISEASE - POLICY LIMIT
S
EL DISEASE - EA EMPLOYEE
$
OTHER
I DESCRIPTION OF
ITEMS
CITY OF FORT COLLINS 58 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
PO BOX 580 EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
��
FORT COLLINS CO 80522-0580 ICI_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
AUTHORIZED