HomeMy WebLinkAbout107125 BIVENS TRUCKING & EXCAVATING INC - INSURANCE CERTIFICATE (7)FTDATE (MM/DD/YYYY)
�Ro® CERTIFICATE OF LIABILITY INSURANCE OP ID ICE
BIVEN-1 12/02/09
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Front Range Insurance Group HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1100 Haxton Drive Suite 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins CO 80525
Phone : 970-223-1804 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: Secura Insurance Companies
INSURER B: Plnnacol Assurance
Bivens Trucking & Excavating,
Aaron Bivens INSURER C:
862 W. Willox Ln INSURERD:
Ft Collins CO 80524
i INSURER 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
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM/DD/YYYY
POLICY EXPIRATION
DATE MM/DD/YYYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
PREMISES (Ea occurence)
$100,000
A
X COMMERCIALGENERAL LIABILITY
CP3145113
12/15/09
12/15/10
CLAIMS MADE L'J OCCUR
MED EXP (Any one person)
$ 5,000
PERSONAL& ADV INJURY
$ 1,000,000
GENERALAGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OPAGG
$2,000,000
X POLICY PRO-
JECT
A
AUTOMOBILE
LIABILITY
ANY AUTO
A3145114
12/15/09
12/15/10
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
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESS / UMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
$
DEDUCTIBLE
$
RETENTION $
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY OFFICER/MEMBOER EXCLUDED? ECUTIVE-r]—1
L
3241983
08/01/09
08/01/10
X TWU LIMITS ER
E.L. EACH ACCIDENT
$ 1, 000, 000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
(Mandatory In NH)
If yes. describe under
SPECIAL PROVISIONS below
E.L. DISEASE -POLICY LIMIT 1
$1,000,000
OTHER
A
Property
CP3145113
12/15/09
12/15/10
A
Equipment ICP3145113
1
12/15/09
12/15/10 1
Lsd & Rnt $100,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
221-6707
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO
CITY OF DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
City of Fort Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Purchasing Division IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Attn:John Stephen REPRESENTATIVES.
PO Box 580
Fort Collins CO 80522
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