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HomeMy WebLinkAbout364578 MISTLER TRUCKING INC - INSURANCE CERTIFICATE (14)From'. Julie McBee At: Truckers' Equity Agency. Inc Faxl D. 303-430-7698 To: City Of Fort Collins Date: 4262011 01:43 PM Page: 1 of 1 OP ID: 02 144c"o?"" CERTIFICATE OF LIABILITY INSURANCE DATE 04126/11 04/261,1 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 endorsements . PRODUCER 303-430-5725 Truckers' Equity Agency, Inc. Mary L. Belleville 303-030-76981AIC. CONTACT NAME: PHONE — Fax NoExU1 AK, N PO Box 417 Wheat Ridge, CO 80034-0417 Julie A McBee EMAIL ADDRESS: -PRODUCER MISTLTR C,T,,ER ID 4: INSURERS) AFFORDING COVERAGE NAIC4 INSURED Mistler Trucking, Inc INSURER A: Wilshire Insurance Company Edward Mistler INSURER°: 50419 CR 21 Nunn, CO 80648 INSURER C: 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. INSR LTR TYPE OF INSURANCE ADOL��DR INSR POLICY NUMBER MMDDY6YY MMAOY, LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY BA2496043 05112111 05f12112 F EMI<zi RENTEDFF� $ 100,000 CLAIM115mPDE a'CCUP MED Ea (A.Imn%111mn) { 5,000 Flz ; SONAL S ADV rWRY a 1,000,000 CBIERALAGGREGATE { 2,000,000 GFN'I. AGG REGATE LIMIT APPL IES PER PRODUCTS-COMPNPAC-G { 1,000,000 X POLICY F hrt LOC f AUTOMOBILE LIABILITY -OMBINED BINGLE LIMIT BE eecidenl) { 1,000,000 _ANY AUTO BODIL'i IH XRY IPelpauo,Q $ ALL OVVNEDAUTVS BODILY IN.URYIFera:CidanO $ A X e.CHEDULEDALITOS IIREDAUTOS BA2496043 05/12/11 05112112 PPOF'EF'TY DAMA�bE T rc,ldxnn $ NON -OWNED AU I OS f UMBRELLA LIAB OCCUR EACH OICUkkrNCE { AGGPEGATE $ EXCESS LIAB QgIMSJdALF _ UEUUCIIULL f RETENTION WO ERS COMPENSATION AND EMPLOYERSLIABILITY YIN AIN PPOPPIFTOPPARTNERIEYECUTIV'E CkYLWINS�_ ETR EL EACH ACCIDENT 4 OFFICERIMEMBER EXCLUDED? NIA ---- -- — EL DEEluE-EAEMROYEE (MandatorylnNH) $ D SCR IPION OF OPERAT IONS M1eInw IEL DISEASE-POLICYLIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEMCLES (Attach ACORD 101. Addlti oral RemaNs Sch edde, if mare space is required) CERTIFICATE HOLDER IS ADDITIONAL INSURED FORTCOL CITY OF FORTCOLLINS FAX 970-221-6707 PO BOX 580 FORT COLLINS, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD