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HomeMy WebLinkAbout364578 MISTLER TRUCKING INC - INSURANCE CERTIFICATE (10)From: Julie McBee At: Truckers' Equity Agency, Inc. FaxID: 303-430-7698 To: City Of Fort Collins Date: 5202009 04:02 PM Page: 1 of 1 ACOFVF CERTIFICATE OF LIABILITY INSURANCE OP ID 02 MISTLTR 05/20/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Truckers' Equity Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Mary L. Belleville HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR PO Box 417 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Wheat Ridge CO 80034-0417 Phone:303-430-5725 Fax:303-430-7698 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A. Wilshire Insurance Company IU�SURER Mistler Trucking, Inc Edward Mistler 50419 CR 21 Nunn CO 80648 USURER E COVERAGES 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 NSRE TYPE OF INSURANCE POLICY NUMBER DATE (MM/DDM'YY) DATE (MM/DD/1'1'YY) LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 1XI OCCUR BA2496043 05/12/09 05/12/10 EACH OCCURRENCE $ 1,000,000 PREMISES (Ea occurence) $100,000 MED FAR (Any one person) $ 5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRO- POLICV JECT LOC PRODUCTS - COMP/OPAGO $1,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BA2496043 05/12/09 05/12/10 COMBINED SINGLE LIMIT (Ea accident) $11000,000 BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTOONLY- EAACCIDENT $ OTHER THAN EA ACC AUTO ONLY. AGO $ $ EXCESS / UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $ $ $ WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICEWMEMBER EXCLUDED? (Mandatory in NH) If yes describe under SPECIAL PROVISIONS below LAT - TORY IMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ FIT .DISEASE -POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / 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 CITYFOR DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN CITY OF FORT COLLINS NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Fin Svc — Purch Div IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR FAX 970-221-6707 215 N MASON SIT2ND FLOOR REPRESENTATIVES. AUT ZED REYRESENT� FORT COLLINS CO 80524 ACORD 25 (2009101) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD