HomeMy WebLinkAboutROCKY MOUNTAIN PAVEMENT - INSURANCE CERTIFICATE (2)acaRD CERTIFICATE OF LIABILITY INSURANCE PID S 8 DAE(MM 8
PRODUCER ROCKYTHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Own ivest Insurance Group ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
dba Peliton Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
4600 S. Ulster St. #1400 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver CO 80237
Phone:303-771-1800 Fax:303-290-0884 INSURERS AFFORDING COVERAGE NAIL
--- - INSURED Employers Insurance Group
INSURER B'. —Colorado casualty Ins Cos
Rocky Mountain Pavement Maint. INSURER
2001 W. 64th Lane nasuaERD.
Denver CO 80221
INSURER E
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THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSJRED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING
ANY REQUIREMENT, I ERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT \NITH RESPECT f0 WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTOALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
tISM '- LTL4'EFFEC 0PTRATIDW
LTR IJSR TYPE OF INSURA14CE POLICY NUMBER DATE (MM/DDI1'Y) DATE (MMIDDA'Y) LIMITS
GENERAL LIABILitt
EACH OCCURRENCE
$1,000,000
B
X
X COMMERCIAL GENERAL LIABILITY
CPP056768503
06/18/08
06/18/09
pREM1I'l5Es (Ed occurenee)
$100,000
CLAIMS MADE o OCCUR
MCD EXP (Any one person)
S 5,000
PERSONAL 8 ADV INJURY
5 1,000,000
_-_
_
GENERALAGGREGATE
$2,000,006
GEN'LAGGREGATE LIMIT APPLIES PER
PRODUCTS - COMP/OP AGO
$2,000, Q00
17 POLICY X PRO-
CT OCI
— -
AUTOMOBILE
LIABILITY
B
X
X
ANY AUTO
CPP056768503
06/18/08
06/18/09
COMDINED SINGLE- LIMIT
(Ea soodenp
$1,000,QQO
ALL OWNED AUTOS
BODILY INJURY
SCHEDULEDAUTOS
(Per person)
$
HIREDAUTOS
BODILY INJURY
$
OUT -OWNED AUTOS
(Per aoc,di
PROPER Y DAMAGE
$
-- -
(Per acodent)
GARAGE LIABILITY
..,
ALAWONLY EAACCIDENT
$
X
fJJY AUTO
OTHER TIiNJ EA ACC
$
AUTO ONLY AGG
$ -
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
( $ 4 , 000 , 000
B
X
X7 OCCUR CLAIMS MADE
CUP05669203
06/18/08
06/18/09
AGGREGATr
$4, 000,000
$
DEDUCTIBLE-
$
X RETENTION $ 0
$
WORKERS COMPENSATION AND
TORYL1['V
EMPLOYERS' LIABILIT'
.4NYPROPRIETOR/PARnJER/Ex.C'_7IVE
EIG1045078-00
07/01/07
07/01/08
ELEHCH AccIDENT I,S1,000,000
Ed FXCLIIDEDo
OI Fyes, ERdescribe
EL DISEASE - [A EMPLOYEE
$ 1, 0 0 0, Q Q Q
er
SPECIAL PROVISIONS below
E 1. DISEASE- POLICY LIMIT
$ 1 , 000 , OQO
OTHER
DESCRIPTIOIJ OF OPERATIONS 1 LOCATIONS / VEHICLES I EXCLUS1014S ADDED BY EIdDORSEME14T I SPECIAL PROVISIONS
City of Fort Collins is added as additional insured.
i I IPII.A I C MULUCK CANCELLATION
CITOFTC SHOULD AIJY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
City of Fort Collins 140TICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Purchasing Dept PO box 580 IMPOSE NO OBLIGATION OR LIABILITY OF AIVY KIND UPON THE INSURER, ITS AGENTS OR
Ft Collins CO 80522 REPRESENTATIVES.
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