HomeMy WebLinkAboutHEIMBUCK DISPOSAL - INSURANCE CERTIFICATE (4)ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID B DATE(MM/DD/YYYY)
HEIMB-1 10 14 04
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Renaissance Insurance Group HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
631 Birch Street, Unit D
Windsor CO 80550
Phone:970-674-8825 Fax:970-674-8826
Heimbuck Disposal, Inc.
Tim Heimbuck
PO Box 270310
Fort Collins CO 80527
OVERAGES
INSURERS AFFORDING COVERAGE NAIC #
INSURER A: Allied Insurance Company
INSURER B: Employers Compensation
INSURER C:
INSURER D:
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 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.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
L FFE TIVE
DATE MM/DD/YY
XPIRATI N
DATE MWDD/YY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 1XI OCCUR
ACPMCT07511662675
11/01/05
11/01/06
EACH OCCURRENCE
E 1000000
PREMISES (Ea occurence)
E 100000
MED EXP (Any one person)
s 5000
PERSONAL B AOV INJURY
$ 1000000
GENERAL AGGREGATE
s 2000000
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY PRO LOC
JECT
PRODUCTS - COMP/OP AGG
s2000000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
ACPBA7511662675
11/01/05
11/01/06
COMBINED SINGLE LIMIT
(Ea accident)
E 1000000
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
S
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
1
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
EXCESS/UMBRELLA LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
E
E
$
$
B
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
FN-329393-01
08/01/06
08/01/07
TORY LIMITS X ER
E.L. EACH ACCIDENT
$500000
E.L. DISEASE - EA EMPLOYEEI
s 500000
E.L. DISEASE -POLICY LIMIT
s 500000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CFRTIFICATF wni nFR CANCELLATION
City of Fort Collins
Purchasing Division
Attn: Ed Bonnette
P.O. Box 580
Fort Collins CO 80525
FTCPURC 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
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE f We!-
A^^MM ne rennnmot
ACORD C ORATION 1988