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HomeMy WebLinkAbout112297 VINEY TRUCKING INC - INSURANCE CERTIFICATE (6)OP ID: KH .41`�R �.•--- CERTIFICATE OF LIABILITY INSURANCE-._.- DATE05112 DIYYYY) sll2n 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 970-635-9400 Insurance Group -JT 970-635-9401 Thompson Pkwy, Ste 200 Johnstown, CO 80534 Tad Borrett Vn CONTACT FAXPFS PHONEo Ext: l/C No): N E-MAIL . ADDRESS: PRODUCER VINEY-1 CUSTOMER ID d: INSURERS AFFORDING COVERAGE NAICd INSURED Viney Trucking, Inc. Dba INSURER A: Pinnacol Assurance 41190 INSURER B: Duane Viney Trucking 2507 Brookhill Rd. Ft. Collins, CO 80524 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 TR TYPE OF INSURANCE ADDL UB POLICY NUMBER MMIDDYIYYYV MMIDDIYYYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑ OCCUR NIA EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL S ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC PRODUCTS - COMPIOP AGG $ $ AUTOMOBILE LABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS NIA COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Par accident) S PROPERTY DAMAGE' (Per accident) $ $ UMBRELLA LAB EXCESS LAB OCCUR CLAIMSWADE N/A EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION S $ $ _ A WORKERS COMPENSATION AND EMPLOYERS 'R/LABILITY ANY PROPRIETOPARTNERIEXECUTIV NN (Mandatory In NH) EXCLUDED? If yee desaibe under DESCRIPTION OF OPERATIONS helow NIA 1963162 BLKT WAIVER OF SUBRO 06/01/11 - 06/01/12 X WCSTATU- OTH- ITO E.L. EACH ACCIDENT $ 100,00 E.L. DISEASE - EA EMPLOYEE$ 100,00 E.L. DISEASE -POLICY LIMIT $ 500,00 05/20101 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more space Is required) CITYFCC CITY OF FORT COLLINS Attn: Jan - Purchasing Dept P O Box 580 FORT COLLINS, CO 80521 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOWED REPRESENTATIVE 9)1988.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD