HomeMy WebLinkAboutSJW TRUCKING - INSURANCE CERTIFICATE (3)FEB-19-2009 15:15 From:AMERICAN FAMILY INS 9706743360 To:9702216707 Pase:2/2
CERTIFICATE OF LIABILITY INSURANCE
American Family Insurance Company ❑
American Family Mutual Insurance Company if selection box is not checked.
6000 American Pky Madison, Wisconsin 53783.0001
Insured's Name and Address Agent's Name, Address and Phone Number (AgL/Dist.)
S,1W TRUCKING INC Christina Wanamaker (970) 674-3223
11083 Highway 14 1200 W. Ash St. Unit F
Atilt, CO 80610 Windsor, CO 80550-4610 (025/316)
This oertificato is issued as a matter of information only and confers no rights upon the Certificate Molder.
This certificate does not amend, extend or alter the coverage afforded by the policies listed below.
COVER A ;::,r.•.. ,._ ... ;, ,,:.:a::?,,'�::::.:::::* '.ii'?iC: 777777,cs: von ,;:
.. ...... ... ...:....::C.:;•.. n•..: ri...,rv.... . :i:a:!-?':'.:. � :' �'si. '^t:;: ,r;^ �p ::a�J'r'"?ti'' - _ !'aL•;, ::is,.- r,v: .
�' Polldes deacrlbed herein $ stabled to all the farms, exclusions, and conditions s, such
�I, • i
... ...............
The is to certify that pallG" of insurance listed polow have been iseueo to the insured named abase for the policy period Indicated, notWthmandin an requirement, term or oondifion of arty contract or ether
doCtimarN with respect to which this certificate may be issued w may Pertain, Ito insurance afforded thv dhlora of such policies.
TYPE OF INSURANCE POLICY NUMBER EFFECTIVE UNHATIDN LIMITS OF LIABILITY
M D v; Moo v
Homeowners/ ownry injury and Prooerty Gomage
Mobilehomeownere Liability Each Occurrence $ .000
Boatowners Liability Andly Injury and Property oamei)a
Each Occurrenca $ o00
Personal Umbrella Liability
Bodily Irgury and Proporty Damage
Each Occurrence $ .000
Farm/Raneh Liability
arm I.lablllty & Perso LmNiity
EaCh Occurrence $ 1000
Perm Employer's LiablPty
Workers Compensation and
Employere Liablilly t
Cacti Occurrence $ 000
Bcatulury
each Accident $ .000
Disease • Each Employee $ 1000
Disease • Policy Limit $ ow
General Liability
eneral
® COmlity (o l Gonna)
Liability (ocourrenco)
General Aggregate $ 4.000 000
products I Completed 0 erabans Aggregate $ 4,000 000
PmeonalandAdvsM n nu $ 2,000
❑
02/23/2009
02/23/2010
Each Occurrence $ 2,000 o00
❑
Q&Ma2e to premises, Ranted to You S 1000W
6usinessowners Liability
Medical Fir nSe (Any one Person) $ rj
Each occurrence't t $ .000
Aggregatett $ 1000
Liquor Liability
Common Cause umlt $ 006
Automobile Liability
❑ Any auto
AWagate tlmrt $ .000
Bodily Irdu(y. Eath Parson $ 1,000.000
® All Owned Autos
2 Scheduled Autos
❑ Hired Auto
Q Nonowned Autos
Boot' usury - Each Aooldonl $ 1,000.000
Property' Damage $ 1,000 ,000
—
Bodily Injury and Frdperly Damago Comtxned $ 1000
50
Excess Liability
❑❑ Cornmareial Blanket Excess
Each Occurrence/Aggregate $ 000
t The individual or partners shown as Insulted u Havo ❑ Have Trot
elected to be covered as, emplayoo* under this policy.
t t PrndiWtu-Ogmpleted Opyratlorts aVagato b spud to each
. .......... ""'CERTIFI....
CATE"HOLDER'M-.ANt7''A.bDRESS "
m policy aggregate. .
,
-
- _.-�,,.,..:.�
. ADDITIONAL INSURED
cancelled
xXpp y of the above doSCribed IICICS be Cancelled before the
e iSrafiorddate thereof, the co n will cleaver to'm days)
written notice to the Cerlific Itn Hotel nemod, but failurio ro malls
CITY OF FORT COLLINS
notice shall impose no obligation or liability d any keel upon the
conpany, its a ents or representatives. •t0 days unja6s diiforont
number of days s�town.
215 N MASON
0 This certifies coverago on the date of issue only, The above
FORT COLLINS, CO 80521
described policies are subject to cancollallon in conformity with their
terms and by rho laws of the state of issue.
.
FAZE AT
r27J/26./27009
R
U•201 Ed- 5100 Certificate
Holder Stock No. Ut3668 Rev. 7J02