HomeMy WebLinkAbout292540 WESTERN ENTERPRISES INC - INSURANCE CERTIFICATE02/23/2009 15:31 FAX IN02
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ACDRD. CERTIFICATE OF LIABILITY INSURANCE DATE(MaIDD1YYYY)
2009
PRODUCER Phone: 440-248-4711 Fax: 440-248-5401 THIS CERTIFICATE I$ ISSUED AS A MATTER OF INFORMATION
BriCton-Gallagher and Associal'�s, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER- THIS CERTIFICATI= DOES NOT AMEND, EXTEND OR
6240 SOM Center Rd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BF -LOW.
Cleveland OH 44139
INSURERS AFFORDING COVERAGE NAIC #
•INSURED -- — INSURERPJ T,exi�T+�ton „�z1suranGe Co ._. - --
Western Enterprises, Inc. INSURERB:�, ni a staCe--
13513 W. Carrier Road I1,16uRERC:Arc eeialCv
Carrier OK 73727 NSURERD:
INSURER E;
COVERAGES
THE POLICIES ON LNSURANCE LISTED BELOW HAVE BEEN ISSUED To THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATEn.
NOTWITHSTANDING ANY REQUIREMENT, PERM 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 TD ALL THE
TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES• AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS:-....
iNSR OD A- TYPP OF INJJUFZANCFpOLICV NUMBER PoucY BFFECTrVE POLI E(PIRATION LIMITS
AR GEHMALLIASILiIi 1619930-01 2/15/2009 2/15/2010 EACH OCCURRENCE --
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CLAIMS MADE REOCCUR.
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PERSONAL & ADV INJURY
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GENQ LAGGREGATE
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AUTOMGBILELIABILnY
CA91835947 2/15/2009
2/15/2010
COMBINEDSINGLELIMIT
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y 1, 000,000
X ANY AUTO
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ALL OWNED AUTOS
BODILY INJURY
(Per PerGo
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SCHEDULED AUTOS
HIREDAUTOS
BODILY INJURY
(Per x6denl)
S
NON-OWNEDAUTO5
PROPERTY DAMAGE
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(PerpmIdenl)
AUTO ONLY• EAACCiDENT
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ULFOOOAS77 2/15/2009
2/15/2010
EACHOCCURRENCE
S4-0C.Q.,O00
�I CLAIMS MADE
AGGREGATE
5,9 O O , 0 �—
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DEDUCTIBLE•
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY E.L.GACHAGCIPSNT 9
ANY PROPRIETORIPARTNVWEXECV nVE E.L. PISEASE- EA EMPLOYEE $
OFFICEwMEMBER EXCLUDED? -
ImYs,desmbuui0v E.L. DISEASE - POLICY LIMIT S
SPECIAL PROVISIONS below
OTHER
DESCRIFIMN OF C•PrRATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY EHOORSEMENY I SPECIAL PROVISIONS
Additional Insureds; City of Fort Collins & its Officers, Agents Ind Employees
id# 6093 - 4th of July Fireworks
Display Date: July 4, 2009
Location: City Park; Fort Collins, CO
City of Fort Collin$
P.0 Box 580
Fort Collins Co 80522-0580
25 (2001108)
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER
WILL, ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE
CERTIPTCATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO
SHALL IMPOSE; NO OBLIGATION OR LIABILITY OF ANY KIND UPON
TNR INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE d7. — A
(D ACORD CORPORATION 1988