HomeMy WebLinkAbout122133 HILGENBERG EXCAVATING INC - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE OP ID XA
ywl
OA 0(MMIDDIY1
06/13 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
NAME:
Brown & Blown Inc
4532 Boardwalk Dr, Suite 200
Fort Collins CO 80525
PHONE
INC, No, Est: (A/C, No):
ADDRESS;
PRODUCER
CUSTOMERIDN: HILGE-1
Phone:970-482-7747 Fax:970-484-4165
INSURER(S) AFFORDING COVERAGE
NAICR
INSURED
INSURER A: Colorado Casualty Ins Co
41785
Hilggenberg Excavating, Inc.
2011 Byline Dr
Fort Collins CO 80526
INSURER B:
INSURERC:
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.
LTR
TYPE OF INSURANCE
ADD
INSR
WVO POLICY NUMBER
POLICY'EFF
(MMIDDIYYYY)
POLICY EXP
(MMIDD/YYYY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1000000
A
X COMMERCIAL GENERAL LIABILITY
CI -AIMS -MADE FxIOCCUR
CBP8634079
06/02/11
06/02/12
PR MISEESS(Eaoccurrence)
$ 100000
MED EXP(My one person)
$ 15000
PERSONAL B ADV INJURY
$ 1000000
•
GENERAL AGGREGATE -
$ 2000000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGO
$2000000
POi ECT LOC
$
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
(Ea accident)
$ 1000000
A
ANY Auro
BA8635979
06/02/11
06/02/12
BODILY INJURY (Per person)
$
ALL OWNED AUTOS
BODILY INJURY (Per accident)
$
X
SCHEDULED AUTOS
HIRED AUTOS
X
PROPERTY DAMAGE
(Per accident)
$
X
$
NON -OWNED AUTOS
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CWMS-MADE
AGGREGATE
$
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY y I N
TORV LIMITS ER
E.L. EACH ACCIDENT
$
ANY PROPRIETORIPARTNERIEXECUTIV
OFFICER/MEMBER EXCLUDED?
/A
E.L. DISEASE - EA EMPLOYEE
$
(Mani in Ni
It yes, describe under
E.L. DISEASE - POLICY LIMIT 1
$
DESCRIPTION OF OPERATIONS below
A
Equipment Floater
CBP8634079
06/02/11
06/02/12
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is required)
Excavation
Attn B. Jackson - Serial#FC96
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
FTCPOLD I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
r2111:1— ltli0
Ft. Collins Police Department
300 LaPorte Avenue
ACORD 25 (2009/09) The ACORD name and logo are