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Home My WebLink About107125 BIVENS TRUCKING & EXCAVATING INC - INSURANCE CERTIFICATE (9)AC®RD CERTIFICATE OF LIABILITY INSURANCE DATE (BIVEN-OPID, DAMMIDD/YYYY) TE( os o9 PRODUCER • THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Front Range Insurance Group HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1100 Haxton Drive Suite 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fort Collins CO 80525 .- Phone : 970-223-1804- INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Secura Insurance Companies - INSURER B: Pinnacol Assurance Bivens Trucking &'Excavating,' `Aaron Bivens INSURER C: 862 W. Willox In INSURERD: Ft Collins CO 80524 - INSURER E: OVERAGES 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD/YY POLICY EXPIRATION DATE MMIDDIYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X COMMERCIAL GENERAL LIABILITY CP3145113 12/15/08 10/01/09 PREMISES(Eaoccurence) $ 100000 CLAIMS MADE F_X] OCCUR MED EXP (Any one person) $ 5000 PERSONAL & ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OPAGG $ 2000000 POLICY PRO- Ll LOC JECT A AUTOMOBILE LIABILITY ANY AUTO A3145114 12/15/08 10/01/09 COMBINED SINGLE LIMIT (Ea accident) $ 1000000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) HIRED AUTOS NON -OWNED AUTOS _ - -- - C. PROPERTY DAMAGE -(Per accident) - - $ — GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ .__ - ----EAACC OTHER THAN $ .. ...__ ...ANY AUTO — -._ _ _.. ._-. .__.._ ... _. ._._ $ ' AUTO ONLY: AGG EXCESS/UMBRELLA, LIABILITY EACH OCCURRENCE $ OCCUR ❑ CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 3241983 08/01/08 08/01/09 X TORY LIMITS I ER E.L. EACH ACCIDENT $ 1 000 000 E.L. DISEASE - EA EMPLOYEE $ 1 , 000 , 000 E.L. DISEASE - POLICY LIMIT $ 1 , 000 , 000 OTHER A Commercial Applica CP3145113 12/15/08 10/01/09 A Property Section CP3145113 12/15/08 10/01/09 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION City of Fort Collins 'Purchasing Division 221-6707 PO Box 580 Fort Collins CO 80522 CITY OF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 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 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. ACORD 25 (2001/08) �� n ACORD CORPORATION 99RR A CORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM 01/08/2009YY) /2009 PRODUCER PINNACOL ASSURANCE 7501 E Lowry Blvd Denver, CO 80230-7006 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: PINNACOL ASSURANCE 41190 BIVENS TRUCKING & EXCAVATING INC 862 W. WILLOX LANE FORT COLLINS, CO 80524 INSURER B: INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDNG 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 POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICYNUMBER DATE(MM/DD(YYYY) DATE(MM/DD/YYYY) LIMITS GENERAL LIABILITY - EACH OCCURRENCE DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR PREMISES MED EXP(Any one person) PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIERS PER: GENERAL AGGREGATE PRODUCTS - COMP/OP AGG POLICY PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea Accident) BODILY INJURY ALL OWNED AUTOS SCHEDULED AUTOS (Per person) BODILY INJURY HIRED AUTOS NON -OWNED AUTOS (Per accident) PROPERTYDAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC ANY AUTO • AUTO ONLY: AG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE AGGREGATE OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND WC STATU- OTHER A EMPLOYER'S LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE 3241983 08/01/2008 08/0112009 TORY LIMITS E.L EACH ACCIDENT $1.000,000 OFFICERIMEMBER EXCLUDED? ' E.LDISEASE- EAEMPLOYEE $1,000,000 If yes, please describe under SPECIAL PROVISIONS below E.L DISEASE -POLICY LIMIT $1000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION 1125447 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 P.O. BOX 580 Fort Collins CO 80522 MAIL 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Nicholas Brown ACORD 25(2001108) Underwriter ACORD CORPORATION 1988