HomeMy WebLinkAbout150588 WALSH CONSTRUCTION INC - INSURANCE CERTIFICATE (5)May 26 10 11:15a
Matthew Walsh
970-278-9396
p.2
'R cd N-fay 26 11:42:12 CDT 21110
SHELTER
�.INSIt RAN
(item #I) Named insured:
WAISH CON817RUCTION INC.
tAVELAND.C%190O 37-9481
Eeidence of Insurance
Motor Carrier Coverage
Ageat
LINDSAY ,A I: NI:: I'I'
C )7fr) '-?7 _C 70'
Policy Number: 05-1-C4999249-6 Effective Date: 045%^6J2019, 1137 AM CentrA Time
__-_.._.._.__.— ..... 1Rxpiration Date: 09117/2010, 12:01 AM Central'1-ime
(Item OR)
(Ifem NZ) Coverages
Vehicle Year blakeJModel
19V4 J%WER i,AA,'LA35Z7
SymDot Deductible
dehicte LID` -�
1I-ITSDPPN0RH57SO?4
Eadorxmem Premium
Number
Sin oJc Liability I J—
_ _
6?
SI-000.00NI =inch
C 309 C;')
UninsWCd M0hxivY
67
S2S0.000 Per Penoa
$}fC00
Split Unitssurd Motorist (C;ov,;rnc=)
67
SSIIU 000 Pr Accident CA 21 0' ' 4h
Collision
67
CSM Dcrla'xihlc
S14:.00
Cotn3rchwsiic
67
3a00 Dccuctiblc
Discounu (Reflected to Plrcaaiums)
PREMIUM S544.00
Other EndorStMCM A1112Cbed To This POliey Eudersrumal Number
A dditional Ittwru!
(:A'1iU_ 4106
LcnS PilS+blc G ua.+c
_ _ CA tKi 44 12 93
Desicnulcc Irsur..d
_ --
CA ^li Sa J3 99
D�ieuulc� Ir_aurxl
['.\ 20 4S 021 99
DaSigewtccftxur_ci
CA 04S0299
nmend:tu,n_t>rtdurvemrnt _
.a-t.'2:-A
C1tanGt ;
—
C'40I 126109
Common Pnlicv Cordilio,n
I L -70 , 7 it 98
Nucldr Encrev L3shilily Exclu;im
IL -W 21 0ri OR
CO Cnnoattn:,nt. Nisrdvrsrall or Fraud
II, i; l 54 09 ri
CO Chancas- Caaoz. ation and Nonrt•ncrval
---
11. i:_ 2S 09 07
1L41'i; CI.ASS I6A 'TERRITORY 006
COST SYMBOL. F PAC.KACE-CD I
LOSS PAY1:4
GUARANTY BANK AND TRUV'TTSAOA
46S0 ROYAL VISTA OR
FORT COLLINS. CO 80:528
LOAN 140.00( 9)1)iNtOtTR7!)
ADU1T[ONAL 1"[Sl1RLD
C'r1Y 0= 13RIGITION
_2S4-THAVE
BR R I(i'H 11)N, C n XCX,01_?Q.9r1
LOAN vO. '
A-62=.1-A
PERM 416
ADDITIONAL INSU.RLWLL•ASL-
CITY OF GREELEY
10W IOTH ST
\ GRL'l:I1iY,CO:l1631-?lOtf
LOAN NO.
ADDITIONAL INSUR ZED
C[IY Olt F C C OT_LINS WATERS WAY
3i5 N MASON ST
FORT C.OLLINS• (x)1t0524.44t12
LOAM NO.
A�-cdt
ADDITIONAL INSLIKU)
CITY OF FORT COLLINS
300 LAPOKTE AVI'
FOI: P COLLINS. co all; -71-2711+
LOAN NO.
May 26 10 11:15a
Matthew Walsh
970-278-9396
p.3
4 cd May 26 1 1:44;49 CDT 2010
i 07,
ALTc:HCUF.I+urr
(item 01) \arced Insured:
WALSH CONSTRUCTION r %C
5139 OPEN VILE ` 11L
LOVI.I AND.CO34S3i-"M
Evidence of Insurance
Motor Carrier Coveraac
Agcm
tl -E I O(1-0 i
Policy Rlttmller: OS-1-C-4949214-7 Effective 'dDnte:0512&2010, 11:43. lil Ccnlral Time
Expiration Dat:c: 03i1712011, 12:01 ANT Central Time
1Ttem t)3) Vehicle Year MzU,' dadel Vehicle IID
r 19:t7 rA(;AL TAGALONG i191ST
jr1cm #.) Coverages Coverage Unilti Endorsement Premium
Symbol Dedoctible Namher
3inelcLiubilitvLmii (; S MID. 000 Urnit
Discounts (Reflected 4n Premiosms) - t R -MlL i S I i,i 6
(Other Endorsements Uti4ched To This Police Codor-Amen Number
Addititnnr! lnsun:d -_•—'• __..�..
C.( 2!I01 (306
Dcsienalcd 1-mti" (A 211 J.4 Ih 09
DC111!n:ItCII t�Itillfpt-------_^-Tl_-------
_.-_..—.-. _....._...-__ CA 2-14S IA 99
Amcndtcory Ladcrsz;rx-ot —----._—_.___.- a-a7L3• a
A ul 1, ui 09
Common Tolicv Corditiors — IL 4X1 17 11 9.1
Kttcicnr Enc:rw Lwhilily Exclusion 11. (K1 : 109 OS
CO CorccshteatL M uepn:scn1 or Frzud `— J L 91 u 1(1 0' — —.�—
{:tl Chstu-(:3=L;11aluat and Nuutc,n:.ad IL 02 2S 0!: 0?
RATL• CL4S3 t6A TERRITORY o03 TLRNI 12
cost SYMUOL B PAt:KAGt-CD I
ADDtTIONA L i\SL;-' LD-LEASE
CITY OF LONGS{ONT. PCBLIC WOP S
4%2RD iVE
LONGMONT. CO Rt1501-5939
LOAN NO.
A-622.1-A
.iDDITTONAL INSURC D
Cry OF GREEL@Y
1J'J(r lori ST
GRCCLCY, CO S0631-380S
LOAN NO.
A=at
�>,OUITIONAL tKSUKt:U
CITY O: Fr COLLINS WATERS IVAY
' 15 N ARSON &TRL"L•T
FORTCOLLIN5.00 Sti>2'.05�U
LOAN X'O.
