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Home My WebLink About273314 THE JENSEN INVESTMENT GROUP - INSURANCE CERTIFICATE (3)Rom® CERTIFICATE OF LIABILITY INSURANCE OP ID LD F55AH(MM/DDmYY) O1/13/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION.IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in'lieu of such endorsement(s). PRODUCER - Brown & Brown Inc NAME. PHONE FAA (AIC, No, Ext : (A/C, No): 125 S Howes, 5 th Floor P O BOX 2226 Fort Collins CO 80522-2226 ADDRESS: CUSTOMER usroMER ID u: STEEL-1 Phone:970-482-7747 Fax:970-484-4165 INSURER(S) AFFORDING COVERAGE NAICN INSURED INSURER A: Continental Divide Ins. Co. 35939 Steely Trucking Inc P 0 Box 633 INSURERB: Pinnacol Assurance Company 41190 INSURERC: Wellington CO 80549 INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR —TADDVSUBR— TYPE OF INSURANCE INSR WVDI POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY Ex (MM/DDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE I $ 1 , 000 , 000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR COA000385 09/27/10 09/27/11 PREMSEES EaoccurrenED ce) $ 100,000 MED EXP (Any one person) $ 5 , 000 PERSONAL &ADV INJURY $ 1 , 000 , 000 X GENERAL AGGREGATE s2,000,000 GENT AGGREGATE'L'IMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ included- " POLICY PROJECT LOC $ A AUTOMOBILE LIABILITY ANY AUTO COA000385 09/27/10 09/27/11 COMBINED SINGLE LIMIT (Ea accident) $1,000,000. BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ X X SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ X NON -OWNED AUTOS $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DEDUCTIBLE $ $ . .RETENTION. $. _ _ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNEPJEXECUTIVFE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) I N / A 475882 01/01/11 01/01/12 X W 7ATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 100000 E.L. DISEASE - EA EMPLOYEES $ 100000 Ues, describe under SCRIPTIONOFOPERATIONS below E.L. DISEASE -POLICY LIMIT 1 $500000 J 7 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) City of Fort Collins included as additional insured regarding commercial general liability. FAX: 568-9813 CERTIFICATE HOLDER CANCELLATION City of Fort Collins 215 N. Mason St. Fort Collins CO 80521 CITYFl O I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE Wmi THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE iiehts reserved ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD