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Certificate of Insurance
Certificate Mailed To: Name of Insured:
CITY OF FORT COLLINS
ATTN: BONNETTE
215 N MASON ST 2ND FLOOR
FORT COLLINS CO 80522
Proof of Coverage
Sales / Collector / Messenger
Various AZ Locations
Job Number:
Location:
BUSINESS ENTERPRISE MAPPING INC
STE D7
8900 E Pinnacle Peak Rd
Scottsdale AZ 85255
Date Issued:
11/16/2009
Certificate Number:
90
Policy Number:
292124
Origin Date:
12/12/1997
Expiration Date:
12/01/2010
Liability Limits:
500/500/500
(000 Omitted)
Coverage under this policy applies to Arizona hired employees only.
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 policy listed hereon. This is to certify
a workers' compensation policy has been issued to the insured listed hereon and is in force for the period
referenced.
Certificate Issued To:
City of Fort Collins
Attn: Barnette
215 N Mason St 2nd Floor
Fort Collins CO 80522
Authorized Representative
61-81001/2D/2OD6