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COPE CONSTRUCTION - INSURANCE CERTIFICATE (5)
ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID DATE(MM/DDIYYYY) COPEC-1 01/15/10 PRODUCER -� u ; I '� v 1 I: YHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Brown & Brown Inc i I ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 125 S Howes, 5th Floor �' MAR 2 2010 I `I I HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O Box 2226 J { ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fort Collins CO 80522-2226 Phone : 970-482-7747 Fax : 970-484 4.165FEB. 1 2010 INSURERS AFFORDING COVERAGE NAIC # INSURED _ INSURER A: Mountain States Mutual 14648 t lt= INSURER B: Cope Construction Kent Coppe dba PO Box 389 LaPorte CO 80535 rnvrPAnPq I'-•, /ER- 22010 INSURERC: INSURER D: INSURER E: 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 LTR 'INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD/YY POLICY EXPIRATION DATE MMIDDIYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A Y % COMMERCIA_GG GENERAL CPP008040508 02/0d/10 02/04/11 ET6R REMISES(Eaoccurence) $ 100000 MED EXP (Any one person) $ 10000 CLAIMS MADE [X] OCCUR PERSONAL & ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OPAGG $ 2000000 POLICY n ECT LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY y' AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS CGMFENS:.TiGN AND TOTH- ORY LIMITS i I ER EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ OFFICER/MEMBER EXCLUDED? if yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Excavation Contractor. The City of Fort Collins is included as Additional Insured on the General Liability as respects the operations of the named insured. L,LK I I11-IUA I t City of Fort Collins Purchasing Division Attn: James B. O'Neill II P.O. Box 580 Fort Collins CO 80522-0580 GANGtLLA I IUN 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. ACORD 25.(2001/08) © ACORD CORPORATION 1988