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HomeMy WebLinkAbout320032 WALDO TRUCKING LLC - INSURANCE CERTIFICATE (2)7/21/2009 12:50 PM FROM: Fax Welsh Ins. PVIS, Inc. TO: 2216707 PAGE: 001 OF 001 ACORO CERTIFICATE OF LIABILITY INSURANCE DTE A07/2109NY) PRODUCER Welsh Insurance Agency, Inc. 4033 Boardwalk Drive, Suite #200 Fort Collins, CO 80525 Phone (970)206-1810 Fax (970)206-1808 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 # INSURED Waldo Trucking, Inc. 9925 Waldo Lane Wellington, CO 80549- INSURER A: UNITED FIRE GROUP INSURER B: PINNACOL INSURER C: INSURER D: INSURER E: COVERAGES INSURER F: THE POLICIES OF INSURANCE LISTED 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 LTR AOD'L INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDDfYY) POLICY EXPIRATION DATE (MWDDNY) LIMITS A ❑ GENERAL LIABILITY �/❑ COMMERCIAL GENERAL LIABILITYDAMAGE ❑❑ CLAIMS MADE Q OCCUR ❑ 60369950 02/08/09 02/08/10 EACH OCCURRENCE 1,000,000 O RENTED PREMISES Ea occurence 100,000 MED EXP (Anyone person) 5,000 PERSONAL & ADV INJURY 1,000,000 ❑ GENERAL AGGREGATE 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER d❑ POLICY []PROJECT ❑ LOC PRODUCTS - COMP/OPAGG 2,000,000 A ❑❑ AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ ALL OWNED AUTOS SCHEDULED AUTOS ❑ HIRED AUTOS ❑ NON OWNED AUTOS ❑ 60369950 02/08/09 02/08/10 COMBINED SINGLE LIMIT (Ea accident) 1,000,000 BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) El ❑ GARAGE LIABILITY ❑ ANYAUTO ❑ AUTO ONLY - EA ACCIDENT OTHER THAN EAACC AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY ❑ OCCUR ❑ CLAIMS MADE ❑ DEDUCTIBLE ❑ RETENTION $ EACH OCCURRENCE AGGREGATE B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 4089513 03/01/09 03/01/10 0 WC STATU- ❑ OTH- TORY LIMITS ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE- POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS I LOCATIONS ! VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT f SPECIAL PROVISIONS EXCAVATION AND HAULING CERTIFICATE HOLDER CANCELLATION City of Fort Collins - PURCHASING DEPARTMENT Attn: Purchasing PO Box 580 Fort Collins, CO 80522 fax 221.6707 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. AUTHORIZED REPRESENTATIVE ACUNU ZO (ZUU1/Ut5) QF © ACORD CORPORATION 1988