HomeMy WebLinkAboutROY EDWARDS E P TRUCKING - INSURANCE CERTIFICATECERTIFICATE OF INSURANCE
STATE FARM
is t at ® STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois
El STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois
i WASIbelol ng policyholder for the coverages indicated below:
1
of policyholder Roy Edwards
Address of policyholder 37153 Northwest Dr
Windsor, CO 80550
Location of operations 37153 Northwest Dr
Description of operations Dump Truck Services
The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is
subiect to all the terms exclusions and mnditinns of thnsa nniiria Tho limits of liahiiitu &Kn mom.. ke..n ties. —A...., 1 6.. _-...._:J
POLICY NUMBER
TYPE OF INSURANCE
POLICY PERIOD
LIMITS OF LIABILITY
Effective Date Ex irsUon Date
at beginning of policy period)
Comprehensive
BODILY INJURY AND
Business Liability
PROPERTY DAMAGE
This insurance includes: ❑ Products - Completed Operations
❑ Contractual Liability
❑ Underground Hazard Coverage
Each Occurrence $
❑ Personal Injury
❑ Advertising Injury
General Aggregate $
❑ Explosion Hazard Coverage
Products - Completed
❑ Collapse Hazard Coverage
Operations Aggregate $
❑ General Aggregate Limit applies to each project
EXCESS LIABILITY
POLICY PERIOD
BODILY INJURY AND PROPERTY DAMAGE
Effective Date Ex iration Date
(Combined Single Limit)
❑ Umbrella
Each Occurrence $
Other
Aggregate $
Part 1 STATUTORY
Part 2 BODILY INJURY
Workers' Compensation
and Employers Liability
Each Accident $
Disease Each Employee $
Disease - Policy Limit $
POLICY NUMBER
TYPE OF INSURANCE
POLICY PERIOD
LIMITS OF LIABILITY
Effective Date Expiration Date
at beginning of policy period)
0848064D2506
86 Kneworth
10 25 04
04 25 05
1 Million
Name and Address of Certificate Holder
City of Fort Collins
Purchasing Department
215 N. Mason
Fort Collins, CO 80524
IT any oT the cescribed policies are canceled before its
expiration date, State Farm will try to mail a written notice to
the certificate holder 30 days before cancellation. If,
however, we fail to mail such notice, no obligation or liability
will be imposed on State Farm or its agents or
representatives.
ignatunAuthorized ,Re sentti
gftm
Title
a -a) -ns
556-984 a 2-90 Printed in u.sA. Date