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Home My WebLink About120140 VARSITY CONTRACTORS INC - INSURANCE CERTIFICATE (3)DATE(M/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE °PARSIKL 08/26/09 Premier Insurance - IF P.O. Box 50340 Idaho Falls ID 83405 Phone:208-522-1260 Fax:208-522-1267 INSURED Varsity Contractors, Inc. PO Box 1692 Pocatello ID 83204 COVERAGES 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 # INSURER A: St. Paul Fire 6 Marine Ins Co 24767 INSURERS: Travelers Property Casualty Co 25674 INSURER C: Travelers Casualty 6 Surety Co 19038 INSURER D: INSURER E: 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 P LI Y EFFE TIV DATE MM/DD/YYYY P LI Y EXPIRATI N DATE MM/DD/YYYY LIMITS GENERALLIABILITY EACH OCCURRENCE $ 1,000,000 PRE MISES(Ea.N.urence) s500,000 B X X COMMERCIAL GENERAL LIABILITY TC2JGLSA1761B75409 09/01/09 09/01/10 CLAIMS MADE a OCCUR MED EXP (Any one person) $ 0 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE s2,000,000 GEN1 AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 POLICY X JET F LOC Emp Ben. 1,000,000 B AUTOMOBILE LIABILITY ANY AUTO TC2JCAP1761B74209 09/01/09 09/01/10 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ ANY AUTO $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $5,000,000 A X I OCCUR F—ICLAIMS QK09400869 09/01/09 09/01/10 AGGREGATE s5,000,000 $ 0DEDUCTIBLE $ X RETENTION $ 10 , 000 B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIV OFFICER/MEMBER EXCLUDED? Im (Mandatory in NH) TC2JUB1761B59808 TRJUB1761B70508 09/01/09 09/01/09 09/01/10 09/01/10 OTH- X TORY LIMITS X ER E.L. EACH ACCIDENT $ 1000000 E.L. DISEASE - EA EMPLOYEE $ 1000000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ 1000000 OTHER C Crime 105169627 09/01/09 09/01/10 Limit $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS All coverages are subject to policy forms, conditions and exclusions. City of Fort Collins is additional insured for General Liability but only with regard to services provided by the insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITYOFF DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL City of Fort Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Director of Purchasing PO BOX 5$O REPRESENTATIVES. Fort Collins CO 80521 AU RIZEDREPRESEyjATIVE ACORD 25 (2009101) U 19BU-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD INTERLINE WI 00 99 07 06 DATE: 07/30/2009 WILSHIRE INSURANCE COMPANY P.O. Box 7006, Lancaster, California 93539-7006 NOTICE OF CANCELLATION / NONRENEWAL To ALL Insureds, Loss Payees, and Other Interests named in the Policy shown below: Additional Interest Policy Number: FORT COLLINS, CITY OF BA2494623 57 02 DIRECTOR OF PURCHASING 215 N MASON, 2ND FLR FORT COLLINS, CO 80522-0000 We are notifying you, in accordance with the Terms and Conditions -of the policy shown above, that your policy will cease at 12:01 a.m. Standard Time at the first Named Insured's Mailing Address on the date shown below: CANCELLATION / TERMINATION DATE OF POLICY: 08/29/2009 PREMIUM ADJUSTMENT: If this policy is cancelled and the premium has not been paid, the earned premium due and payable shall be computed as provided in the policy, and demand is hereby made for payment thereof. If premium' has been paid, `the excess paid premium above the earned premium, if any, if not tendered with this Notice of11 Canoellation/Nonr'enewal, will be refunded as soon as practicable after cancellation becomes effective. The following, when applicable, have also been AVAILABILITY OF OTHER INSURANCE notified (by separate notice) Certificate Holder(s), We are notifying you that we are cancelling your policy for Additional Insured(s) . or Interest(s), and all Commercial Automobile. insurance, Other insurance is Domestic and Foreign Motor Carrier Regulatory possibly available through your agent, another insurer or Entities. through the Automobile Insurance Plan. For additional information, please contact your insurance agent. Named Insured: SAINTS TRUCKING, LLC 4502 HIBISCUS ST FORT COLLINS, CO 80526-0000 i I Countersigned at Lancaster. California on 07/30/09 Authorized. Representative Countersignature"- .; Policy.lssued through Agency: Producer Code:.. 000300001- : - TRUCKWRITERS OF COLORADO INC 1410 CARR STREET = LAKEWOOD, CO 80214-6102 WI 00 99 07 06 Page 1 of 1 ADD'L INSURED 07/30/2009 11111111 IN N III 1111111111111111111111111111111111 I I 1 I 111111111111111111111111111111111111111111111111111111 IN N 111111111111111111111111111111111111111111111111111111111111111111111111111 I I I111111111111111