HomeMy WebLinkAbout320030 MORRIS TRUCKING - INSURANCE CERTIFICATE (6)01/26/2009 03:20 9706637183 PAGE 01
.ac�Q'aca� CERTIFICATE OF LIABILITY INSURANCE-oATE(MAAloD/YY)
_ : __._._._..... -- - _—_._..... __ _ ........__... _... ..._ ...... _ 01/26/09 i
PRODUCER Welsh Insurance Agency, Inc. THIS CERTIFICATE. I$ ISSUED AS A MATTER OF INFORMATION
1310 East Eisenhower Dlvd. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
i HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
j Loveland, CO 80537 ALTER THE COVERAGE AFFORDFD BY, THE, POLICtE¢ LOW.,• ••
Phone (970)663-5404 Fox (970)663-7183 INSURERS AFFORDING COVERAGE NA_IC #
l
INSURED Morris Trucking LLC INSURER,A:
_ . UNITED FIRE..GROUP -.._-.-�•.__-.- . __. .._, ,
7050 ECr INSURER B:
;.INSURER C;:
Wellington, CO 60549- INSURER 6:
(970) SW9438
_....
INSURER E: i
COVERAGES INSURER F:
THE POLICIES OF INSURANCE USTED 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
iMAY 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 SEEN REDUCED BY PAID CLAIMS.
INM
ADD'L I
TYPE OF INSURANCE POLICY NUMBER
iPOLICY EFFECTIVE POLICY EXPIRATION
L pATE (MM/DD/YY] .. DATE LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
1000000;
'
COMMERCIAL GENERAL LIABILITY
60376523
6AIVb4Gi Tb-FtNTED —_...-
09/08/08 09/08/09 PREMISES.(Ea occur!ence)_
--
100000:
�T CLAIMS MADE OCCUR
MED EXP (Any one person)
5000
A �J r
PERSONAL & ADV liij'
1000000
GENERALAGGREGATE
2000000'
GEN'L AGGREGATE LIMIT APPLIES 'PER :j
2000000
POLICY L_a PROJECT � LOC i.....
- -- r- ........ ..........-.........._._..._..._....._ .......... _ ...
AUTOMOBILE LIABILITY
l7
C SINGLE LIMIT
......... .._ ..._ ..,
10OOra
ANY AUTO 60376523
(Eaa accident)
09/08/08 09/08/09 ccident)
i
I.Y.! ALL OWNED AUTOS
l
BODILY INJURY
A j [�/f �....I SCHEDULEDAUTOS I
(per person)
[..... HIRED AUTOS
BODILY INJURY
NON OWNED AUTOS
(Per accident)
i
I .•f
PROPERTY DAMAGE
Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
�._ i ❑ ANY AUTO j
_.__ ........__.... _......._._.. ................-.._.
OTHER THAN EA ACC
-- --..
_l
__......
AUTO ONLY: AGG
—.
EXCE33AJMBRELLA LIABILITY
EACH OCCURRENCE
OCCUR ;., I CLAIMS MADE I
AGGREGATE
7 DEDUCTIBLE
RETENTION S
'WORKERS COMPENSATION AND --------.s• _- - -
CC gg tt�� p
I
EMPLOYERS' LIABILITY
• • TQRY(TIITS... ERH ;...-.
..
I ANY PROPRIETOR / PARTNER / EXECUTIVE
E.L. EACH ACCIDENT
OFFICER I MEMBER EXCLUDED? I
- -
.. _.... ........ .
If yea, deSCI'ibe Under
E.L. DISEASE - EA EMPLOYEE
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
; OTHER
I
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
CERTIFICATE HOLDER IS ADDITIONAL INSURED.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
CITY OF FORT COLLINS STREETS
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO
P O BOX 58O
THE LEFT, BUT FAILURE TO DO $0 SMALL IMPOSE NO OBLIGATION OR LIABILITY
FORT COLLINS, CO 80522
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES,
AUTHORIZED REPRESENTATIVE
..LFAX 221-6y07
_- -- - ---
l: Welsh Insurance Agency, Inc.
ACORD �5 (2001/08} QF
(b ACORD CORPORATION-1888 •- ••;
01/26/2009 03:20 9706637183 PAGE 02
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.
^%.vrav Fa Swu uupJ W