HomeMy WebLinkAboutMCBRIDE WATER LLC - INSURANCE CERTIFICATEFeb 20 08 11:42a Dax Mattox State Farm
970 879 7775 P.1
,gcoRo® CERTIFICATE OF LIABILITY INSURANCE °ATE(MMA)DNYYY)
02/20/2008
PRODUCER THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION
Dax Mattox Insurance Agency, INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1915 Alpine Plaza Ste C2 HOLDER- THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Steamboat Springs, CO 80487 ALTER THE COVERAGE AFFORDED wv Tug ODI Ir•Icc ccI n...
LNSURED
McBride Water LLC
779 Amethyst Dr
Steamboat Springs, CO 80487
INSURERS AFFORDING COVERAGE
NSURERA State Farm Fire and Ca
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITFISTANDING
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.
INSR
LTA
A
IMSRD ILD W
TYPE OFiNSURAMCE
OEHERALLIA&uTr
X COMMERCIALGENER4L LlABIitt
POUCY NUMBER
Pending
POLICYEFFECTIME
DATE MUMO
02/14/08
POUCyr)(MRATION
DATE MIND
02/14/09
UMDS
EACH OCCURRENCE
11000,000
CLAMSMADE OCCUR
PREMISES eommv�w
MEOE%P M orle
$
$ 5,000
--
PERSONAL& ADV INJURY
S 1, 0001000
GENLAGGRE3OTEtM`APPLPSFEN,
GENERAL AGGREGATE
S 21 0001 OOC
PRODUCTS-OOIN,OPAGG
S 2, 000, COO
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AUTOMOBILE
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COMBINANYAUTO (Ea amHornsINGLE LIMIT
S
ALL OWNED AUTOS
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BODILY INJURY
(Pm PalStll)
S
HUREDAUTOS
NON GAINED AUTOS
BODILY JU
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S
MOPERTYDAMAGE
(Pa/ac w)
$
GARAGE LIABILITY
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S
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SEIICESSIUMBRELLA
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➢ESCRf"ION OF OPERATIONS I LOCATIONS I VEHICLES I "CLUSRONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
Business Miscellanous
CERTIFICATE
Fort Collins Utilities
Attn Opal Dick SHOULD ANY THE ABOVE DF3CRIBEp POLICIES BE CANCELLED, BEFORE ME ERRATpON
700 DATE THEREOF, THE ISSUING INSURER WILL III TO MAIL , DAYS WRITTEN
For Wood Street NODCETOTHECTHTRFICATEHMDER"MDTOTHEM".BMFArWI 7OWWSHALL
Fart Collins, CO $OS22-O5B0 Fax (970)221-6619 IMPOSE NO OBLIGATgNOR LIABILITYR OFANY KIND UPON THE INSUREITSAGENTS OR
Dax Mattox, Agent
Feb 20 08 11:43a Dax Mattox State Farm
970 879 7775 p.2
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 cerMcate holier in lieu of such endorsement(s).
If SUBROGATION IS WANED, subject to the terns 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.
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