HomeMy WebLinkAbout206064 ARNOLD BURNS DBA A & B TRUCKING - INSURANCE CERTIFICATE (8)ACORD CERTIFICATE OF LIABILITY INSURANCE OP ►D DATE (MMI/YV
ABTRUCI 08 0306
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Truck Insurance Specialists HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
6075 E. 60th Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Commerce City CO 80022
Phone:800-880-0975 Fax:303-287-2311
INSURED
A 6 B Trucking
420oEast 57thr1y5Burns dba
Loveland CO 805#55538
INSURERS AFFORDING COVERAGE NAIC #
INSURER& Wilshire Insurance Company
INSURER B:
INSURER C:
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.
IN
LTR
AWW
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY
DATE MM/DDIYY EFFECTIVE
DATE MMIDDm N
LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE F7 OCCUR
EACH OCCURRENCE
$
PREMISES (Ea occurence)
$
MED EXP (Any one person)
$
PERSONAL B ADV INJURY
$
GENERAL AGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER:
PRO
POLICYLI JECT LOC
PRODUCTS-COMP/OP AGG
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
BA2480056
07/08/06
07/08/07
COMBINED SINGLE LIMIT
(Ea accident)
$ 1 OOO OOO
r r
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
PROPERTYDAMAGE
(Per accident)
$
GARAGE
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
THAN EA ACC
AUTO ONLY: AGG
$
$
EXCESSIUMBRELLA LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
$
$
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFtCER/MEMBER EXCLUDED?
H yes, describe under
SPECIAL PROVISIONS below
TWU LIMITS ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEEI
$
E.L. DISEASE -POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
The Additional Insured endorsement is on file with the Insurance Company
with respects to Auto Liability coverage.
CITYFO2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
City Of Fort Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Purchasing Dept.
PO BOXox 560 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Fort Collins CO 80524 REPRESENTATIVES.
25 (2001/08) (C) Amen cnRPnRATlnNI IORR
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
2s 12nnvnal