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Home My WebLink About206064 ARNOLD BURNS DBA A & B TRUCKING - INSURANCE CERTIFICATE (3)OP ID acoRD CERTIFICATE OF LIABILITY INSURANCE ABT 0 DATE(/30 Y08 ABTRUCI 07 30 08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HUB Transportation (CO) 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 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER Wilshire Insurance Com aII INSURER B A & B Trucking Arnold & Beverly Burns dba INSURER 420 East 57th #55 wsuRERD Loveland Co 80538 — INSURER E VVY.R/ CJ 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 LIFDMW TR NSR TYPE OF INSURANCE POLICY NUMBER DATE NUI IEE YY DATE MM/UD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE E OCCUR PREMISES(Ea occurence) $ MED EXP Any one person) $ PERSONAL S ADV INJURY $ GENERAL AGGREGATE $ GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS COMPIOPAGG $ POLICY JEo LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED (Ea accdentSINGLE LIMIT $ 1 000 000 A ALL OWNED AUTOS SCHEDULED AUTOS BA2480056 07/08/08 07/08/09 BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ HIRED AUTOS NON OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTOONLY EAACCIDENT $ ANY AUTO OTHER THAN EA ACC $ $ AUTO ONLY AGG EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY TORY LIMITS ER EL EACH ACCIDENT $ ANY PROPRIETOR/PARTNEWEXECUTIVE OFFICER/MEMBER EXCLUDED' Byes describe under EL DISEASE EA EMPLOYEE $ E L DISEASE POLICY LIMIT $ SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / 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 PurchasingBox580 Dept PO Sox 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR Fort Collins CO 80524 REPRESENTATIVES (2001108) 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