HomeMy WebLinkAbout107125 BIVENS TRUCKING & EXCAVATING INC - INSURANCE CERTIFICATE (8)7/22/2009 11:24:28 AM Front Range Insurance Group 19706928290
ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID KE DATE(MMIDDIYYYY)
BIVEN-1 07/22/09
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: Pinnacol Assurance
Bivens Trucking & Excavating,
Aaron Bivens INSURER C:
862 W. Willox In INSURER D:
Ft Collins CO 80524
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
DATE (MMIDDIYYj
POL EXPIRATION
DATE (MMIDDIYY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1000000
A
$ COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FX I OCCUR
CP3145113
12/15/08
10/01/09
PREMISES(Eaoccurence)
$ 100000
MED EXP (Any one person)
$ 5000
PERSONAL & ADV INJURY
$ 1000000
GENERAL AGGREGATE
$ 2000000
GEN'LAGGREGATE LIMIT APPLIES PER :
PRODUCTS - COMPfOPAGG
$2000000
POLICY PRO-
JECT LOC
A
AUTOMOBILE
$
LIABILITY
ANY AUTO
A3145114
12/15/08
10/01/09
COMBINED SINGLE LIMIT
(Ea accident)
$ 1000000
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per person)
$
HIRED AUTOS
NON -OWNED AUTOS
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR ❑ CLAIMS MADE
AGGREGATE
$
$
DEDUCTIBLE
$
$
RETENTION $
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETORfPARTNERfEXECUTIVE
3241983
08/01/08
08/01/09
TORY LIMITS I $ ER
E.L.EACHACCIDENT
$1 000 000
E.L. DISEASE - EA EMPLOYEE
$ 1 , 000 , 000
OFFICER/MEMBER EXCLUDED?
Ifyes, describe under
E.L. DISEASE- POLICY LIMIT
$ 1, 000 , 000
SPECIAL PROVISIONS below
OTHER
A
Property
CP3145113
12/15/08
10/01/09
A
Equipment
CP3145113 1
12/15/08
10/01/09
Lsd & Rnt $725,000
DESCRIPTION OF OPERATIONS I LOCATIONS [VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
221-6707
CERTIFICATE HOLDER CANCELLATION
City of Fort Collins
Purchasing Division
Attn:Don Stephen
PO Box 580
Fort Collins CO 80522
CITY OF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
kt-VKU Z> (LUUTlUif) 0 ACORD CORPORATION 1988