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HomeMy WebLinkAbout127666 MICHAEL TRUCKING - INSURANCE CERTIFICATE (15)AGO RD CERTIFICATE OF LIABILITY INSURANCE
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1
PRODUCERPINASSURANCE
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
501 Lowry Blvd
7501 E o
Denver, CO 80230-7006
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC#
INSURED
INSURERA: PINNACOL ASSURANCE
41190
DWIGHT J MICHAEL DBA MICHAEL TRUCKING
INsuaea a:
2450 W. Elizabeth Street
Fort Collins, CO 80521
INSURER CINSURER
INSURER D:
INSURER E'
COVERAGES
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 DOCUMMENT 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
ADDL
POLICY EFFECTIVE
POLICYEXPIRATION
LTR
INSRD
TYPE OF INSURANCE
POLICYNUMBER
DATE(MM)DMYY)
DATEMMNDNYYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
DAMAGE TO RENTED
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE F OCCUR
PREMISES
MEDEX An o
PERSONAL B ADV INJURY
GEN L AGGREGATE LIMIT APPLIERS PER:
GENERALAGGREGATE
PRODUCTS-COMP/OP ADS
POLICY PROJECT LOG
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
ANYAUTO
Ea Accident)
BODILYINJURY
ALL OWNED AUTO$
SCHEDULEDAUTOS
Par P..n
BODILY INJURY
HIRED ALTOS
NDN-0WNEDAUTOS
Pn ecc'Jenl
PROPERTY DAMAGE
(PerecclEant)
GARAGE UABILRY
AUTO ONLY - EA ACCIDENT
OTHER THAN EA ACC
MY AUTO
AUTO ONLY. AGO
E%CESSNYBRELLA LIABILITY
EACH OCCURRENCE
AGGREGATE
OCCUR CLAIMSMADE
DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
WC STATU- OTHER
A
EMPLOYERS LIABILITY
ANY PROPRIETORIPARTNER ECUnVE
4149369
07/13/2011
07/01/2012
TORYUMITS
E.L EACH ACCIDENT
$100,000
OFFICERtT,EMBER E%CLUOEDi
EL DISEASE -EA EMPLOYEE
$,pp,ppp
If yea. Pleaae deamoe uWsr SPECIAL PROVISIONS Eebw
E.LMSEA$E-POUCYLIMIT
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OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHIC LESIEXC LUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
1323949
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
JOHN STEVENS
THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
215 NORTH MASON ST.
MAIL 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
FORT COLLINS CO 80524
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Courtney Prusse
ACORD 25(2001108)
New Business Representative ACORD
CORPORATION 1988