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HomeMy WebLinkAbout107125 BIVENS TRUCKING & EXCAVATING INC - INSURANCE CERTIFICATE (5)03/21/2006 02 41 9702233236 SKIES WEST PAGE 01 D� CERTIFICATE OF LIABILITY INSURANCE O6/a8/2008 PRODUCER 31KxE8 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION $T INS AGENCY INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1531 RrnMIDE AVS UNIT A HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR SORT CO INS CO ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW 80525 _ INSURERS AFFORDING COVERAGE RIV Ep _ERA ALLIED GRODF GIVENS CKING 6 EXCAVATING, iNC 862 W LLOx IN FORT COiGIOREGATE INS CO 80524- )OVERAG THE POLIS OF INSURANCE LISTED BELOW RAVI ANY REQUEMENT TERM OR CONDITION OF ANY MAY PERT THE INSURANCE AFFORDED BY THE POLICIES LIMITS SHOWN MAY HAVE I A I�OM�LALMS MADE Z OCCUR �NUTY ���Jj LAM9 MgpE OCCUR II+CF QLO 7530063,335 PER AUTOMOSILE LIABILITY ANYAUTO B ALL OWNEO AUTOS SCHEOULSO AUTOS © HIRED AUTOS IIIVVVIII NON-bWNED AUTOS TJI061KER8 LIASILITY I GARAGE LIABILITY ❑ ANY AUTO J OCCUR U CLAIMS MADE DrOUCTIBLE RETENTION S WORKERS COMPENSATION AND EMPLOYERS LUUNN CITY OF FORT COLLINS FORC4"rM DEFT F O SOX 580 FORT COLLINS CO 80522— (970) 221-6707 INS URtR B INSURER C INSURER 0 TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR 'RIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH ) BY PAID CLAIMS I 06/20/2008 06/20/2009 COMBINED SINGLE LIMIT (ES ewWerX) BODILY INJURY (I Px vereanJ 03/16/2008 03/16/2009 BODILY INJURY �(Perec,4am) FERTY DAMAGE AUTO ONLY Eq ACCIbEn OTHER THAN EA A(A( AUTO ONLY A( EACH OCCURRENCE AGGREGATE I P Il 1,000 z.00o 1,000 000 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLEp BEFORE THE EXPIRATION DATE THOR90F THE ISSUING INSURER WILL ENDFAVOR TO MAIL 010 DAYS WIBTTEN NOTICE TD THE ,,RrMATE HOLOETL NAMED TO THE LEFT BUT FNWBE TO DO80 SHALL IMPOSENOOBLIGAT10NORLLABILITY6FANY NO UPON THE INSURER, ITS AGENTS OR PROM(TFR CERTIFICATE OF LIABILITY INSURANCE DATE(MMOs/z4/2006 YY) rzooa —T — PINNACOL ASSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY 7501 E Lawry Blvd AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS Denver CO 80230 7006 CERTIFICATE DOES NOT AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW INSURERS AFFORDING COVERAGE NAIC# INSURED BIVENS TRUCKING &EXCAVATING INC 1NsuRERA PINNACOL ASSURANCE I 41180 — 862 W WILLOX LANE INSUR_E_RB FORT COLLINS CO 80524 WSURER C INSURERD — — — INSURERE — — — — — COVERAGES 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 DOCUMMENT 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 LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS POLICIES4DD INSR APOLICYEFFECTIVE POLICYE%PIMTIONLTR IN—_ TYPE OF INSURANCE POLILYNLMBER DATE(MMIDD/YYYYI_ OATE(MMIDDMYY) LIMITS _ — GENERAL UABW TY EACH OCCURRENCE COMMERCIAL GENERAL TO RE LIABILITY DAMAGE NTED CLAIMS MADE LI OCCUR PREMISES _ MED EXP(Any P X 1 _ _ PERSONAL B ADV INJURY GEN L AGGREGATE LIMITAPPLIERS PER GENERAL AGGREGATE POLICY I ' PROJECT ^ LOL PRODUCTS CCMPIOPAGG — — AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (E A d o ALL OWNED AUTOS BODILY INJURY L_1 SCHEDULEDAUTOS (p P rs ) — HIRED MRCS BODILY INJURY NCN-0WNED ALUCS (P - d-0 PROPERTY DAMAGE (P d D GARAGE LIABIOTY AUTOONLV EAACCIDENT ANY AUTO ~ 1 OTHERTHAN EA ACC —_ _ AUTO ONLY AGO `EXCE89NMBRELLA LIABILITY EACH OCCURRENCE ODOUR FI CLAIMS MADE AGGREGATE — _ DEDUCTIBLE RETENTION $ � WORKERS COMPENSATION AM WC STATU OTHER EMIR LOVER 9 MABW TY A 3241963 08/01/2008 0a/01/2009 TORY LIMITS _ ANVPROPRIETOWPACLUDE EL EACH ACCIDENT $1000000 EFECUTIVE OFFICERM,EMBER EXCLUDED If PI E b tl SPECIAL PROVISIONS low ELDISEASE EAEMPLOYEE $1000000 OTHER ELDISEASE POLICYLIMIT 1 $1000 GOO DESCRIPTION OF OPERATIONS/LOCATIONSWEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION 1 001051 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF FORT COLLINS THE EXPIRATION DATE THEREOF THE ISSUING COMPANY WILL ENDEAVOR TO PURCHASING DIVISION MAIL 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE P O BOX 580 LEFT BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR FORT COLLINS CO 80522 LIABILITY OF ANY KIND UPON THE COMPANY ITS AGENTS OR REPRESENTATIVES AUTHORRED REPRESENTATIVE Aundrla Martin AcoRD z zoovoe ) _ Underwnter ACORD CORPORATION 1988 _ CERTIFICATE HOLDER COPY CITY OF FORT COLLINS PURCHASING DIVISION P O BOX 580 FORT COLLINS CO 80522 IMPORTANT If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) 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 after the coverage afforded by the policies listed thereon