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Home My WebLink About150588 WALSH CONSTRUCTION INC - INSURANCE CERTIFICATE (6)Policy Issued By Shelter General Insurance Co. Columbia, MO 65218-0001 wro; 1-800-SHELTER Notice to the Additional Insured: Your interest will be continuous until cancellation notice is mailed to you. Nerned Insured... WALSH CONSTRUCTION INC 8139 OPEN VIEW PL LOVELAND CO 80537-9481 IIIIIIIIIVIIIII�IIIIIII Policy Declarations and Schedule Motor Carrier Coverage Addl. Interest or Addl. Insured Copy SHELTER INSURANCE COMPANIES (05-OE100-01) 4025 AUTOMATION WAY STE C4 FORT COLLINS CO 80525 PHONE: 970-377-2070 Policy Number: 5-1-C-4999249-7 Effective Date: September 22, 2010, 01:27 P.M. Central Time Policy Form Number: CA 00 20 0310 Expiration Date: March 17, 2011, 12:01 A.M. Central Time Policy and Endorsements are available upon request Al.tem #3) Vehicle Year Makelflltodel Vehicle ID 1987 TAGAL TAGALONG 119187 Bodily Injury and Property Damage Received For This Reissue: NONE Other Endorsements; Attached To This Policy . Endorsement Number Additional Insured CITY OF LONGMONT, PUBLIC WORKS CA 20 01 03 06 Designated Insured CITY OF FT COLLINS WATERS WAY CA 20 48 02 99 Designated Insured CITY OF GREELEY CA 20 48 02 99 Amendatory Endorsement A-672.3-A Changes CA 01 13 01 09 Common Policy Conditions IL 00 17 11 98 Nuclear Energy Liability Exclusion IL 00 21 09 08 CO Concealment, Misrepresent or Fraud IL 0169 09 07 CO Changes- Cancellation and Nonrenewal IL 02 28 09 07 (Information May Continue on Back) (For Office Use Only) P.C. RATE CLASS 16A TERRITORY 3 TERM 12 H.O. CODE 154.00 05262010 DATE ISSUED: 09232010 COST SYMBOL B PACKAGE -CD 1 TIER: N/A Countersigned By A-2.54-A 5-1-C-4999249-6 FwjPolicy Issued By Shelter General Insurance Co. .Columbia, MO 65218-0001 1-800-SHELTER / 0-.0W-LIFE (Item #1) Named Insured: WALSH CONSTRUCTION INC 8139 OPEN VIEW PL LOVELAND CO 80537-9481 ***MANUAL DEC*** Policy Declarations and Schedule Motor Carrier Coverage Agent MATTHEW D FOLOT (05-E 100-01) 4025 AUTOMATION WAY UNIT C4 FORT COLLINS CO 80525 PHONE: 970-377-2070 Notice to the Mortgagee/Loss Payee/Designated Insured: Your interest will be continuous until cancellation notice is mailed to you. Policy Number: 5-1-C-4999249-6 Effective Date: October 21, 2010, 10:04 A.M. Central Time Policy Form Number: CA 00 20 03 06 Expiration Date: March 17, 2011, 12:01 A.M. Central Time (Item #3) Vehicle Year Make/Model 1994 INTER #AAA3527 (Item #2) Coverages Coverage Symbol Bodily Injury and Property Damage 67 Collision 67 Comprehensive S7 CO Uninsured Motorists Cov Limits 67 Split Uninsured Motorist (Coverage) 67 Other Endorsements Attached To This Policy Additional Insured CITY OF GREELEY Designated Insured CITY OF FT COLLINS WATERS WAY Designated Insured CITY OF FORT COLLINS Loss Payable Clause Designated Insured CITY OF BRIGHTON Amendatory Endorsement Changes Common Policy Conditions Nuclear Energy Liability Exclusion CO Concealment, Misrepresent or Fraud CO Changes - Cancellation and Nonrenewal (Information May Continue on Back) (For Office Use Only) Vehicle ID 1 GTSDPPNORH578074 Limit/ Endorsement Premium Deductible Number $1,000,000 Limit $228.00 $500 Deductible $99.00 $500 Deductible $57.00 $250,000 Per Person CA 21 50 01 08 $500,000 Per Accident CA 21 02 11 06 P.C. RATE CLASS 16A TERRITORY 3 TERM 6 H.O. CODE 414.00 09232010 DATE ISSUED: 10212010 COST SYMBOL F PACKAGE -CD 1 TIER: N/A Received For This Reissue: NONE Countersigned By Endorsement Number CA 20 01 03 06 CA 20 48 02 99 CA 20 48 02 99 CA 99 4412 93 CA 20 48 02 99 A-672.3-A CA 01 13 01 09 IL 00 17 11 98 IL00210908 IL 01 69 09 07 IL 02 28 09 07 b b A-2.54-A Page 1 5-1-C-4999249-6 LOSS PAYEE: ADDITIONAL INSURED: GUARANTY BANK & TRUST CITY OF GREELEY ISAOA 1000 107H ST 4650 ROYAL VISTA DR GREELEY CO 80631-3808 FORT COLLINS CO 80528-0000 DESIGNATED INSURED: DESIGNATED INSURED: CITY OF LONGMONT CITY OF FORT COLLINS WATER WAY 1100 S SHERMAN ST 215 N MASON ST LONGMONT CO 80501 FORT COLLINS CO 80524-4402 DESIGNATED INSURED: DESIGNATED INSURED: CITY OF FORT COLLINS CITY OF BRIGHTON 300 LAPORTE AVE 22 S 47H AVE FORT COLLINS CO 80521-2719 BRIGHTON CO 80601-2030 bb A-2.54-A Page 2 Policy Issued By Shelter General Insurance Co. Z E t Columbia, MO 65218-0001 AUTO WME.. 1-800-SHELTER Notice to the Additional Insured: Your interest will be continuous until cancellation notice is mailed to you. WALSH CONSTRUCTION INC 8139 OPEN VIEW PL LOVELAND CO 80537-9481 Policy Declarations and Schedule Motor Carrier Coverage Addl. Interest or Add]. Insured Copy LINDSAY ARNETT (05-OE100-01) 4025 AUTOMATION WAY STE C4 FORT COLLINS CO 80525 PHONE: 970-377-2070 Policy Number: 5-1-C-4999249-7 Effective Date: May 26, 2010, 11:43 A.M. Central Time Policy Form Number: CA 00 20 03 06 Expiration Date: March 17, 2011, 12:01 A.M. Central Time Policy and Endorsements are available upon request _(Itemi43) 1Tehcle Year Make/fl Qdei Vehlcte ID 1987 TAGAL TAGALONG 119187 Bodily Injury and Property Damage 1 67 $1,000,000 Received For This Reissue: $154.00 NONE Additional Insured CITY OF LONGMONT, PUBLIC WORKS CA 20 01 03 06 Designated Insured CITY OF FT COLLINS WATERS WAY CA 20 48 02 99 Designated Insured CITY OF GREELEY CA 20 48 02 99 Amendatory (Endorsement A-672.3-A Changes CA 01 13 01 09 Common Policy Conditions IL 00 17 11 98 Nuclear Energy Liability Exclusion IL 00 21 09 08 CO Concealment, Misrepresent or Fraud IL 01 69 09 07 CO Changes,' Cancellation and Nonrenewal IL 02 28 09 07 (Information May Continue on Back) i (For Office Use Only) P.C. RATE CLASS 16A TERRITORY 3 TERM 12 H.O. CODE 154.00 03222010 DATE ISSUED: 05262010 COST SYMBOL B PACKAGE -CD 1 TIER: N/A Countersigned By A-2.54-A 0 0 N Shelter Insurance Companies o 1817 W Broadway Columbia, MO 65218 0 1-800-SHELTER AUTO -L.0 HOM • UFE POLICY NUMBER: 5-1-C-4999249-7 001410 ADD1052610 CITY OF FT COLLINS WATERS WAY 215 N MASON STREET FORT COLLINS CO 80524-4402 Policy Issued By Shelter General Insurance Co. Columbia, MO 65218-0001 AUTO. „om . � 1-800-SHELTER Notice to the Additional Insured: Your interest will be continuous until cancellation notice is mailed to you. (Fern. #1) Named ir►sur�d .. ; .. . WALSH CONSTRUCTION INC 8139 OPEN VIEW PL LOVELAND CO 80537-9481 Policy Declarations and Schedule Motor Carrier Coverage Addl. Interest or Addl. Insured Copy Policy Number: 5-1-C-4999249-7 Effective Date: October 21, 2010, 10:08 A.M. Central Time Policy Form Number: CA 00 20 03 10 Expiration Date: March 17, 2011, 12:01 A.M. Central Time Policy and Endorsements are available upon request (Item #) 1/ehicla Year Make/Model VQhucle ID ..... 1987 TAGAL TAGALONG 119187 Received For This Reissue: NONE Uther Endorsements Attached To `This Policy Endorsemeri!# Numtier Additional Insured CITY OF LONGMONT, PUBLIC WORKS CA 20 01 03 06 Designated Insured CITY OF LONGMONT CA 20 48 02 99 Designated Insured CITY OF FT COLLINS WATERS WAY CA 20 48 02 99 Designated Insured CITY OF GREELEY CA 20 48 02 99 Amendatory Endorsement A-672.3-A Changes CA 01 13 01 09 Common Policy Conditions IL 00 17 11 98 Nuclear Energy Liability Exclusion IL 00 21 09 08 CO Concealment, Misrepresent or Fraud IL 01 69 09 07 CO Changes- Cancellation and Nonren (Information May Continue on Back) (For Office Use Only) P.C. RATE CLASS 16A TERRITORY 3 TERM 12 H.O. CODE 154.00 09232010 DATE ISSUED: 10212010 COST SYMBOL B PACKAGE -CD 1 TIER: N/A Countersigned By IL 02 28 09 07 S 0 N O ca A-2.54-A 5-1-C-4999249-6 *� +� Policy Issued By W Shelter General Insurance Co. Columbia, MO 65218-0001 ® 1-800-SHELTER (Item #1) Named Insured: WALSH CONSTRUCTION INC 8139 OPEN VIEW PL LOVELAND CO 80537-9481 ***MANUAL DEC*** Policy Declarations and Schedule Motor Carrier Coverage Agent MATTHEW D FOLOT (05-E100-01) 4025 AUTOMATION WAY UNIT C4 FORT COLLINS CO 80525 PHONE: 970-377-2070 Notice to the Mortgagee/Loss Payee/Designated Insured: Your interest wm be cununuuus unm canceiiauun nonce is maned to you. Policy Number: 5-1-C-4999249.E Effective Date: October 21, 2010, 10:04 A.M. Central Time Policy Form Number: CA 00 20 03 06 Expiration Date: March 17, 2011, 12:01 A.M. Central Time (Item #3) Vehicle Year Make/Model Vehicle ID 1994 INTER #AAA3527 1GTSDPPNORH578074 (Item #2) Coverages Coverage Limit/ Endorsement Premium Symbol Deductible'Number Bodily Injury and Property Damage 67 $1,000,000 Limit $228.00 Collision 67 $500 Deductible $99.00 Comprehensive 67 $500 Deductible $57.00 CO Uninsured Motorists Cov Limits 67 $250,000 Per Person CA 21 50 01 08 Split Uninsured Motorist (Coverage) 67 $500,000 Per Accident CA 21 02 11 06 Received For This Reissue: NONE Other Endorsements Attached To This Policy Additional Insured CITY OF GREELEY Designated Insured CITY OF FT COLLINS WATERS WAY Designated Insured CITY OF FORT COLLINS Loss Payable Clause Designated Insured CITY OF BRIGHTON Amendatory Endorsement Changes Common Policy Conditions Nuclear Energy Liability Exclusion CO Concealment, Misrepresent or Fraud CO Changes - Cancellation and Nonrenewal (Information May Continue on Back) (For Office Use Only) P.C. RATE CLASS 16A TERRITORY 3 TERM 6 H.O. CODE 414.00 09232010 DATE ISSUED: 10212010 COST SYMBOL F PACKAGE -CD 1 TIER: N/A Countersigned By ?1 Endorsement Number CA 20 07 03 06 CA 20 48 02 99 CA 20 48 02 99 CA 99 44 12 93 CA 20 48 02 99 A-672.3-A CA 01 13 01 09 IL 00 17 11 98 IL00210908 IL01690907 IL 02 28 09 07 bb A-2.54-A Page 1 5-1-C-4999249-6 INN. Shelter Insurance Companies ***MANUAL DEC*** I 1817 W Broadway �� Columbia, MO 65218 ® 1-800-SHELTER POLICY NUMBER: 5-1-C-4999249-6 CITY OF FORT COLLINS WATER WAY 215 N MASON ST FORT COLLINS CO 80524-4402 Z].