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HomeMy WebLinkAbout446423 SJW TRUCKING - INSURANCE CERTIFICATECERTIFICATE 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 (Agt./Dist.) SJW TRUCKING INC Christina Wanamaker (970) 674-3223 11083 Highway 14 1200 W. Ash St. Unit F Ault, CO 80610 Windsor, CO 80550-4610 (025/316) 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 listed below. COVERAGES This is to certify that 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. TYPE OF INSURANCE POLICY NUMBER POLICY T LIMITS OF LIABILITY EFFECTIVE EXPIRATION Mo Day, Yr(Mo. Day, Yr Homeowners/ Bodily Injury and Property Damage Mobilehomeowners Liability Each Occurrence $ 000 Boatowners Liability Bodily Injury and Property Damage Earh OCCUrrenre $ ,000 Personal Umbrella Liability Bodily Injury and Property Damage Each Occurrence $ 000 Farm/Ranch Liability Farm Liability & Personal Liability Each Occurrence $ '000 Farm Employer's Liability Each Occurrence $ 000 Workers Compensation and Statutory Each Accident $ 000 Employers Liability t Disease -Each Employee . $ - ,000 - Disease - Policy Limit $ '000 General Liability gg gate General A re ' $ ' 4,000 ; 000 Products -.con pieie i operations Aggregate' :$ 4,000 00 ® Commercial General , Liability (occurrence) ❑ ❑ 02/23/2009 02/23/2010 Pe?sonal and Advertisih Injury $ 2,000 Each Occurrence $ 2,000 ,000 Damage to Premises Rented to You $ 100 000 Medical Expense (Any One Person) $ 5 Ooo Businessowners Liability Each Occurrencet t $ '000 Aggregatett $ 000 Liquor Liability Common Cause Limit $ '000 Aggregate Limit $ ,000 Automobile Liability ❑ Any Auto ® All Owned Autos BodilyInjury Each Person fry $ 1,000 ,000 Bodily Injury - Each Accident $ 1,000 ,000 ® Scheduled Autos ❑ Hired Auto Property Damage $ 1,000 Opp ❑ Nonowned Autos © Bodily Injury and Property Damage Combined $ ,000 Excess Liability ❑ Commercial Blanket Excess El Each Occurrence/Aggregate $ ,000 Other (Miscellaneous Coverages) DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / RESTRICTIONS / SPECIAL ITEMS t The individual or partners shown as insured ❑ Have ❑ Have not elected to be covered as employees under this policy. tt.Products-Completed Operations aggregate is equal to each • occurrence limit and is included in policy aggregate. _ � CERTIFICATE HOLDER'S NAMEAND ADDRESS?'-' - , , . ~ °' CANCELLATION ADDITIONAL INSURED Should any of the above described policies be cancelled before the expiration date thereof, the company.will endeavorto mall ( days) written notice to the'Certificate Holder named; but failure to mail such CITY OF FORT COLLINS notice shall impose no obligation or liabilityof any kind `upon the company, its agents or representatives. *10 days unless different number of days shown. - 215 N MASON ❑ This certifies coverage on the date of issue only. The above FORT COLLINS, CO 80521 described policies are subject to cancellation in conformity with their terms and by the laws of the state of issue. DATE ISSUED AUTHORIZED REPRESENTATIVE 2/26/2009 C� t.lL�tt.� k) U-201 Ed. 5/00 Certificate Holder Stock No. 06668 Rev. 7/02