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Home My WebLink About107125 BIVENS TRUCKING & EXCAVATING INC - INSURANCE CERTIFICATE (11)FROM PNODUCER SKIES WEST INS AGENCY INC 2601 SOUTH LEMAY #38 FORT COLLINS, CO 80525 IN6UREG SIVENS TRUCKING E EXCAVATING, INC 3900 IDRAL DRIVE SORT COLLINS CO 90526- Pn\leoercc SKIES WEST INS RGCY, INC. PHONE NO. : 970 223 3236 AiC CERTIFICATE OF LIABILITY INSURANCE 02/22/2oos 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. INSURERS AFFORDING COVERAGE IN6URERA ALLIED GROUP —.-..--..---- INSURERS: BXNANCSAL IIiOEMNTTY COMPANY INSURER C:—� INSURER D; INSURER E: ~� Feb. 24 2005 11:49AM P1 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDTO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN. 7HE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGR[CATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTRNSR; TYPE OF INSURANCE POLICY NUMBER POLICY EFFE12AA du CTIVE POLICY E7(PIRATION LIMITS GENERAL uA81LITY ! p' COMMFROIAL 75900fi1335 06-20-2004 06-20-2005 EACH OCCURRENCE _ S 1, 000, 000 �l^J L'ENF,j'.ALLIAS1,11Y iGLO p�E pAMAGE(MYona Fro ; 90,000 .. ❑• CLAIMSMAUG .®. OCCUR! _ MEDEXP A( Yryglgpereen $ 5.000 ;.❑ PERSONAL & ADV INJURY : 1, 000, 000 GENERAL AGGREGATE i , 2,000,000 i��Cp.k7l,lL AGGREGATE LIMIT APPLIES PER: I PRODUCTS- COMPbOP A" S 2,000,000 L^„I� �POLICY '❑ PRE. ❑. LOC AUTOMOBILE LIABILITY ❑• ANY AU) U BIKED SINGLE LIMIT COMBINED i 1,000,000 _ ❑, ALLowNF.0 Aut'OS ;C 7809575 B SCHEOULEDAUTOS 03-16-2004 03-16-2005 BODILY INJURY (Per PS13M) i ❑' HIRED gUl'US ! BODILY INJURY v i �❑ NON -OWNED AUTu$ (Per ACCW6A1) LYAB, _TRUCKERS - _- PROPERTY DAMAGE (Per Molded) i GARAGE LIABILITY AUTO ONLY. EA ACCIDENY i _ OTHER THAN EA ACC E ❑ ANYAUTO �—� AUTO ONLY' AGG $ EXCESS LIABILITY EACH OCCURRENCE i -- OCCUR ❑CIAIM.SMADE AGGREGATE $ __ S D[UUCTISLE I _❑ ❑ RETENTION Si WORKERS COMPENSATION AND ! 7ATU- OTH- E.L. EACH ACCIDENT $ EMPLOYERS' LIABILITY E.L. DISEASE • EA EMPLOYEf $ AJ _ E.L. DISEASE, POLICY LIMIT $ OTHER DESCRIPTION OF OPERAT40NS1LOCAYIpN&VEHIGLEStEXGLU310NS ADDED BY ENOORSEMENTISPECIAL PROVISIONS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF FORT COLLINS PURCHA9IN6 DIVISION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 01O DAYS WRITTEN PO CHA $£i 0 NOTICE TO THE CERTIRCATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL BOXIMPOSE NO OBLIGATION OR LIABILITY OF ANY RIND UPON THE INSURER ITSAOENTS OR PORT COLLINS CO 80522- REPRESENTATIVES, AUTHO ZED REPRES (970) 221-'6707 ACORD 25-5 (7197) @ACORD CORPORATION 1988 Date: 2/22/05 Time: 12:31 PM To: @ 91970-221-6707 Pinnacol Assurance Page: 002.003 PRODUCER Pinnacol Assurance 7501 E Lowry Blvd DENVER CO 80230-7006 INSURED BIVENS TRUCKING & EXCAVATING INC 3900 IDEAL DRIVE FORT COLLINS CO 80524 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 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 MAYBE 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. GO I TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DAi mrNaaJ DAT mm'aa/ r L LIABILTYGENERALAGGREGATE EACTALGENERAL LIABILITY PRODUCTS COMP/0PAGO AIMS MADE ❑ OCCUR PERSONAL&ADV INJURY R'S & CONTRACTOR'S PROT c eru —„o..— AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT BODILY INJURY ALL OW NED AUTOS SCHEDULED AUTOS HIREDAUT03 BODILY I WURY NON OWNED AUTOS axid[nl PROPERTY DAMAGE GARAGE LIABILITY AVTO ONLI' � EA A(k]DENT OTHER THAN AVTO ONLY: ANY ALTO FACH AC M` NT EXCESS LIABILITV EAC C URRENCE AGGREGATE UMBRELLA FORM OT HER TITAN UMBRELLA FORM WON RSCOMPENSATIONAND KiWCSTATU OTHER EMPLOYERS' LIABIIIrV TORY LIMITS _ :'::'" A 3241983 08/0V2004 08/01/2005 ELEACHACCIDENT $1 000 000 ELDISEASE-POLICILIMIT $1000000 THE PROPRIETOR/PARTNERS/ INCL EL DISEASE - EA EMPLOYEE 1 000 000 EXECUTIVE OFFICERS ARE: EXCL OTHER DFSCRIFI'IONWOPERATIONSIWCATIONSIVEHICLES/SPECIALM MS SEE BACK OF CERTIFICATE FOR CLASS COVERAGE AND OWNERSHIP COVERAGE DETAIL 815839 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE I'HE THE CITY OF FORT COLLINS EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL PURCHASING DIVISION 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 LIABILITY OF ANY HIND UPON THE COMPANY ITS AGENTS OR REPRESENTATIVI AUTHORIZED REPRESENTATIVE Kristin Trujillo HUPMARECCBRSYppwi 02P?2-5V313 3NI5 I VPJAW� 12JLSII h12'00:00 UIVU: Date: 2/22/05 Time: 12:31 PM To: 91970-221-6707 CERTIFICATE HOLDER COPY Pinnacol Assurance Page: 003-003 THE CITY OF FORT COLLINS PURCHASING DIVISION PO BOX 580 FORT COLLINS CO 80522 POLICY NUMBER: 3241983 BUSINESS LOCATION: BIVENS TRUCKING & EXCAVATING INC CLASSIFICATION OF OPERATION COVERAGE COVERAGE RATING CLASS DESCRIPTION EFFECTIVE EXPIRES TYPE 621705 EXCAVATION & DRIVERS 08/01/2004 08/01/2005 EM 722805 TRUCKING: LOCAL HAULING ONLY- ALL EMPLOYEES & DRIVERS08/01/2004 08/01/2005 EM 874205 OUTSIDE SALESPERSON 08/01/2004 08/01/2005 EM 881005 EXCLUSIVELY OFFICE 08/01/20o4 08/01/2005 EM