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HomeMy WebLinkAbout364578 MISTLER TRUCKING INC - INSURANCE CERTIFICATE (13)From: Julie McBee At: Truckers' Equity Agency, Inc. FaxID: 303-430-7698 To: City Of Fort Collins Date: 3/5/2010 09:20 AM Page: 1 of 1 . E!O,Fz � CERTIFICATE OF LIABILITY INSURANCE OPID 02 ., %" ' .. �� MISTLTR 03/05/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Truckers' Equity Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Mary L. Belleville HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR PO Box 417 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW., Wheat Ridge CO 80034-0417 Phone:303-430-5725 Fax:303-430-7698 INSURED Mistler Trucking, Inc Edward Mistler 50419 CR 21 Nunn CO 80648 COVERAGES INSURERS AFFORDING COVERAGE NAIC # INSURER A: Wilshire Insurance Company INSURER B INSURER C: 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. IMK LTR 11NSRC TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MWDD/YYYY) POLIC Ex RATION DATE (MM7DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY BA2496043 05/12/09 05/12/10 RREMISES(Eaoccurence) $100,000 CLAIMS MADE FX] OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 POLICY JEa LOC AUTOMOBILE LIABILITI' ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ 1 000 000 � � A X ALL OWNED AUTOS SCHEDULED AUTOS BA2496043 05/12/09 05/12/10 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY 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 COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? S TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) If yes. describe under E.L. DISEASE - POLICY LIMIT $ SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS 7 VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate Holder is Additional Insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITYFOR DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN CITY OF FORT COLLINS NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Fin Svc - Purch Div IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR FAX 970-221-6707 215 N MASON SIT REPRESENTATIVES. 2ND FLOOR AUInZ.ED RE(?RESENT,� n FORT COLLINS CO 80524 ACORD 25 (2009/01) ©1988-2009 ACORD CORPORATION. All rinhts rasarvad The ACORD name and logo are registered marks of ACORD