HomeMy WebLinkAboutSMITH THOMAS - INSURANCE CERTIFICATEACORD. CERTIFICATE OF LIABILITY INSURANCE 06/02/06 ""'
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
CUSTOMER SERVICE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1-800-423-6789 __ALTER THE COVERAGE AFFORDED BY THE POLICIES_ BELOW._
INSURED
SMITH,THOMAS R & KAREN M
1675 HEWLETT GULCH RD
LIVERMORE CO 80536-9511
rnVFRAnFA
INSURERS AFFORDING COVERAGE NAIC #
INSURERA: PROPERTY & CASUALTY INS CO of HARTFORI 34690
INSURERS:
INSURERC:
INSURER D:
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.
7R POLICYNUMBER POLICY EFFECTIVE I POLICY EXPIRATION_ LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
COMMERCIAL GENERAL LIABILITY
�6
' PREMISES (Eaoaurence
• CLAIMSMADE OCCUR
MED EXP(Any one person)
RSONAL&ADVINJURY
__ _ _
_
_
GENERAL AGGREGATE
_
GEN'L AGGREGATE LIMIT APPLIES PER:
-...,.1
PRODUCTS - COMP/OP AGG
POLICY PRO• LOG
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
ANY AUTO
(Ea accident)
X
I ALL OWNED AUTOS
55PHF551651
03/21/06
03/21/07
SCHEDULEDAUTOS
BODILY INJURY
(Perperson) $250,000
HIRED AUTOS
NON-OWNEDAUTOS
(Beraccdent) $500,000
PROPERTYDAMAGE
;$100,000
(Peraccident)
GARAGE LIABILITY
AUTO ONLY -EA ACCIDENT
j
ANY AUTO
OTHERTHAN EA ACC
AUTOONLY: AGG
EXCESSIUMBRELLA LIABILITY
EACHOCCURREN_C_E
AGGREGATE
OCCUR L�CLAIMS MADE
DEDUCTIBLE
-�— --
-
--
I RETENTION
WORKERS COMPENSATION AND
WCSTATU- OTH-
Y IT
EMPLOYERS' LIABILITY
_ __ -
._......
ANYPROPRIETORIPARTNER/EXECUTIVE
E.L. EACH ACCIDENT
E.L. DISEASSEE-- FA EMPLOYEE
--- -- —
OFFICERIMEMBER EXCLUDED?
j
Ifyesdescribeunder
El. DISEASE - POLICY LIMIT
—
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES / EXCLUSIONSADDED BY ENDORSEMENT/SPECIAL PROVISIONS
88 FORD F250 1FTHX26H2JKB24266
IIa:LamIaaa
CITY OF FORT COLLINS
PO BOX 580
FT.COLLINS,CO 80522
ATTN BILL TOMERLIN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
AUTHORIZED REPRESENTATIVE
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