HomeMy WebLinkAbout124167 STEELY TRUCKING INC - INSURANCE CERTIFICATE (3)ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID P DATE(MM/DD/YYY9)
STEEL-1 12/09/09
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Brown & Brown Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
125 S Howes, 5th Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
2226 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P
O Box
Fort Collins CO 80522-2226
Phone:970-482-7747 Fax:970-484-4165
INSURED
Steely Trucking Inc
P O Box 633
Wellington CO 80549
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INSURERS AFFORDING COVERAGE
INSURER A: CONTINENTAL DIVIDE INSURANCE
INSURERB: Pinnacol Assurance
INSURER C:
INSURER D:
INSURER E:
NAIC #
35939
41190
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.
INSR ADD'L POLICY NUMBER
LTR INSRD TYPE OF INSURANCE
POLICY EFFECTIVE POLICY EXPIRATION LIMITS
DATE MM/DD/YY DATE MMIDD/YY
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A X X COMMERCIAL GENERAL LIABILITY COA000385
DAMAGE TO RENTED-
09/27/09 09/27/10 PREMISES (Ea occurence)
$ 100 000
,-
J CLAIMS MADE X OCCUR
MED EXP (Any one person)
$ 5 , 000
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$2,000,000
COMP/OP AGG
�$ 1 000 000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS -
— - -
, ,
- --
POLICY PRO-
JECT LOC
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
$ 1,000,000
A ANY AUTO COA000385
09/27/09 09/27/10 (Ea accident)
ALL OWNED AUTOS
—
BODILY INJURY
$
X SCHEDULED AUTOS
(Per person)
X HIRED AUTOS
BODILY INJURY
$
X NON -OWNED AUTOS
(Per accident)
_
PROPERTY DAMAGE
! $
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
I $
ANY AUTO
OTHER THAN EA ACC
$
AUTO ONLY: AGG
$
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
_L$ -
OCCUR CLAIMS MADE
AGGREGATE
$
DEDUCTIBLE
$
RETENTION $
$
WORKERS COMPENSATION AND
ll. TORY LIMITS ER
EMPLOYERS' LIABILITY
B 1475882
01/01/10 01/01/11 E.L. EACH ACCIDENT
$ 100,000
ANY PROPRIETOR/PARTNER/EXECUTIVE
- — -
OFFICER/MEMBER EXCLUDED?
E.L. DISEASE - EA EMPLOYE
$ 100 , 000
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE -POLICY LIMIT
$ 500 , 000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
City of Fort Collins included as additional
insured regarding commercial
general liability.
FAX: 568-9813
r CPTIFICATF N(U P1FR CANCELLATION
CITYFI0
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
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
Purchasing Dept.
215 N. Mason St.
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Fort Collins CO 80521
REPRESENTATIVES.
HOR ED REPRESENTATI
ACORD 25 (2001/08) V AUUKU UUKFUu(AI IUN IU66