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Home My WebLink AboutWAYNES DIRT WORK WAYNE KONTZ - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE _OP ID, DATE IMIA 0Dmm1 Brown 6 Brown Inc 125 S Howes, 5th Floor P O Box 2226 Fort Collins CO 80522-2226 Phone 970-482-7747 Fax 970-484-4165 INSURED _ - -- Wayne's Dii_rt Work PO BoxR162 dba Bellvue CO 80512 COVFRAnce cn, Iriu I e Is 13SUCU As A MATTER OF INFORMA AND CONFERS NO RIGHTS UPON THE CERTIFICATI ER THIS CERTIFICATE DOES NOT AMEND EXTEND t THE COVERAGE AFFORDED BY THE POLICIES BE INSURERS AFFORDING COVERAGE + NAIC 0 YINSURERA Mountain _States Mutual 14648 INSURERS _Pin_na_co_1 Assurance_Companyt 41190 l INSURERC- INSURER D INSURER - — -- -- -- -- - 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 POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID TO ALL THE TERM$ EXCLUSIONS AND CONDITIONS OF SUCH NW -- _— _— _ _—_ CLAIMS LTR INSR TYPE OF INSURANCE POLICY NUMBEfl EFFECTIVE - DA NMIDEFF DIVE�- DATE GENERAL LIABILITY MMIDDIYY LIMITS A X X_ COMMERCIAL GENERAL LIABILITY CPP007279008 EACH OCCURRENCE $1,000,000 08/17/08 08/17/09 $ CLAIMS MADE OCCUR I PREMISES E.100,000 ��J�� MEDEXP(My.-pawnwo) $ 10,000 rJ PERSONALS ADV INJURY sl,OOo,000 -- GEN LAGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2, 000, QQQ _ r POLICY � — LOC PRODUCTS COMP/OPAGG 32, 000, OOQ J�ECTp -- AUTOMOBILE LIABILITY M ANY AUTO COMBINED LIMIT Oe�tlEDSINGLE ) S ALL OWNED AUTOS I� __ SCHEDULED AUTOS BODILY INJURY (ParP�) HIREDAUTOS $ NON -OWNED AUTOS PerOecctdwt)RY PROPERTY DAMAGE - ---� (Px acWdmq $ GARAGE LIABILITY ANY AUTO AUTO ONLY EA ACCIDENT $ -OTHER EA ACC 1 S AUTO ONLY AGG $ EXCESSNMBRELLA LIABILITY J OCCUR L-1 CLAIMS MADE EACH OCCURRENCE y AGGREG AGGREGATE _ S I 1 DEDUCTIBLE --4 $ RETENTION j -- — $ WORKERS COMPENSATION AND S B EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE 4047562 L�TORY LIMITS ER OFFICER/MEMBER EXCLUDED? Ilya tleaibounEx SPECIAL PROVISIONS bebw 06�01/08 06/01/09 EL EACH ACCIDENT $1000QQ_ I __ _ EL DISEASE EA EMPLOYE $ 1o000Q -- OTHER EL DISEASE POLICY LIMIT $500000 DESCRIPTION OF OPERATONS I LOCATGME I VEHICLES / EXCLUSIONS ADDED BYE -RSEMEM/ SPECWL PROVISIONS City of Fort Collins is included as additional insured under the general liability CERTIFICATE HOLDER City Of Fort Collins Purchasing 281 N College Avenue Fort Collins CO 80522 CITYPT55 SHOULD AM OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SMALL IMPOSE NO OBLIGATION OR LIABILITY OF AM MIND UPON THE INSURER ITS AGENTS OR