HomeMy WebLinkAbout359019 LITTLE BOYS TRUCKING LLC - INSURANCE CERTIFICATE (7)04/02/2010 10:43 9704843210
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FUSA(NOLAND JOHN C
121 F SWALLOW RD #115
FT COLLINS, C,0 80525
970-484-3200
Certificate of Insurance
[crtificate Holder
lnsurcd
Additional Insured
LITTLE BOYS TRUCbNG, LLC
CITY OF'FT COLLINS
2302 STANLEY CT
PO BOX.580
FT COLLINS, CO 9052G
FT COLONS, C0.80522
P/SiDGRE,I Iff,
Policy number: 05351504-1
Underwritran by:
ARTISAN AND TRUCKERS CASI,IALTY CO
April 2, 2010
Page 1 of 1
Anent
........ ..........................................................
�����FUSAINOLAND JQHN C
121 E SWALLOW RD #115
rT COLLINS, CO 8092S
This document certifies that insurance policies identified below have been issued by the designated insurer to the
Insured named above for the period(s) indicated. This CerLikdle i5 i5yued fui irIfurrnatiarr purposes only. It confers no
rights upon the certificate holder and does not change, alter, modify, or extend the coverages afforded by the policies
listed below. The coverages afforded by the policies listed below are subject to all the terms, exclusions, limitations,
endorsements, and conditions of these policies.
.....................................................................................................
....
.......
Polity Effor_tiv? Date: Mar Z5, 2014 Polity fYriratinn natp Mar 75, 7n11
hmirance coverage(s) Lhwm
....................................................."M. B,........,1N" ...............................
90DILY INIURYlPROPERTY DAMAGE $i,000,000 COMBINED SINGLE OMIT
UNINSURED/UNDERINSURED MOTORIST $-100,000 COMBINED SINGLE LIMIT
Description of Locatian/Vehides/Special Items
Scheduled autos only
.............
...... .................................S.tated Amo........ M-o"....,..$'2"8,00-0-0 ..
1991 kW T60 1XKADR9X7MS559220unt..52
MEDICAL PAYMENTS $5,000
COMPRF„HFNSIVE $1,000 DEC)
COLLISION $1,000 DED
Certificate number
0921ONET504
Please be advised that additional insureds and loss payees will be notified in the event of a mid -tern
cancellation.
Ram 5241 (10102)
FUSAMOLAND JOHN C
121 E SWALLOW RD #115
FT COLLINS, CO 80525 002256
PROGREIRYE'
CITY OF FT COLLINS
PO BOX 580
FT COLLINS, CO 80522
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Additional insured endorsement
Name'of Person or Organization
CITY OF FT COLLINS
PO BOX 580
FT COLLINS, CO 80522
Policy number: 05351504-1
Underwritten by:
Artisan and Truckers Casualty Co
Insured: LITTLE BOYS TRUCKING, LLC
March 27, 2010
Policy Period: Mar 25, 2010 - Mar 25, 2011
Mailing Address
Artisan and Truckers Casualty Co
PO Box 94739
Cleveland, OH 44101
800-444-4487
For customer service, 24 hours a day,
7 days a week
The person or organization named above is an insured with respect to such liability coverage as is
afforded by the policy, but this insurance applies to said insured only as a person liable for the conduct
of another insured and then only to the extent of that liability. We also agree with you that insurance
provided by this endorsement will be primary for any power unit specifically described on the
Declarations Page.
Limit of Liability
Bodily Injury Not applicable
Property Damage Not applicable
Combined Liability $1,000,000 each accident
All other terms, limits and provisions of this policy remain unchanged.
This endorsement applies to Policy Number: 05351504-1
Issued to (Name of Insured): LITTLE BOYS TRUCKING, LLC
Effective date of endorsement: 03/25/2010 Policy expiration date: 03/25/2011
Fon 1198 (01/04)