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Home My WebLink About384033 J J'S TRUCKING - INSURANCE CERTIFICATE (4)MY IDDYYY ,4co d CERTIFICATE OF LIABILITY INSURANCE DATE 12/" 08' PRODUCER THIS CERTIFICATE IS ISSUED AS MATTER OF INFORMATION Lisa Kelly of Cramer State Farm ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1275 E Magnolia St Suite I Fort Collins CO HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR 80524 1 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW INSURED PFLIPSEN, STAN dba JJ S TRUCKING 221 W DOUGLAS RD LOT 17 FORT COLLINS CO 80524 INSURERS AFFORDING COVERAGE Fire and 25143 NAIC III 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 MSR LTR ADDL MSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE POLICY EXPIRATION DATE X �, LIABILITY COMMERCIAL GENERAL LIABILITY CLAWSMADE OCCUR 96-BB-D290-3 F 03/23/08 03/23/09 EACH OCCURRENCE f 1 000 000 PREMISE Ea oroarance a 1 000 000 NED EXP a $ 5 000 PERSONAL S ADV INJURY a 1 000 OOD GENERAL AGGREGATE $ 2 OOO 000 GBNLAGGECATELWTAPPLESP9t PRO POLICY 0 JECT LOC PRODUCTS COfP/OPAGG a 2 000 000 X AUTOMOBILE LIABILITY ANY Auro ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS 117 3516-D10-06G-001 150 7989-BO4-06C-001 146 2119-A16-06D 146 2108-A16-06D 10/10/O8 08/29/08 07/16/08 08/29/08 04/10/09 02/04/09 01/16/09 01/16/09 COMBINED SINGLE LIMB (Ea acpdenl) a 1 000 000 BODILY INJURY (Per Pa,aOa) S 1 000 000 X BODILY INJURY (Pwe dmt) f 1 000 000 PROPERTY DAMAGE (Pxa dalA) a 1 000 000 GARAGE LIABILITY ANY AUTO AUTO ONLY -EA ACCIDENT f OTHER THAN EAACC AUTO ONLY AGG S EXCESSNMBRELLA LIABRJTY OCCUR CLAMS MADE DEDUCTIBLE RETENTION S EACH OCCURRENCE f AGGREGATE S a $ f r.WORKERS S LIABILITY ITY AND EMPLOYERS LIABILITY ANY PROPRIETORIPARTNEREXECUTIVE OFFICERANEMBER EXCLUDED? If yyaecs SPECIAL PROVISIONS below WC STATU- OILY LIMB ER ER E L EACH ACCENT f EL DISEASE EA EMPLOYEE S E L DISEASE POLICY LMR IS OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS CITY OF FORT COLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION 215 N MASON ST DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN FORT COLLINS CO 80521 NOTICE TO THE CERTIFICATE HOLDER MIMED TO THE LEFT BUT FAILURE TO DO SO SNALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR 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 ACORD 25 (2001108)