HomeMy WebLinkAboutDOUBLESTROKE TRUCKING LLC - INSURANCE CERTIFICATE (3)POLICY NUMBER: GWP86978A
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL AUTO COVERAGE PART
The provisions of the Coverage Form apply unless modified by this endorsement.
This endorsement changes the policy effective on the inception date of the policy unless another date is
indicated below.
Named Insured
Endorsement Effective
DOUBLESTROKE TRUCKING LLC
MARCH 7 2012
Endorsement Number
GREAT WEST CASUALTY COMPANY
6
FLOOD & PETERSON INSURANCE INC 0560
SCHEDULE
Policy Expiration Date: MAY 23 2012
Name of Additional Insured:
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS CO 80522
Description of Covered "Auto(s)":
APPLIES TO ALL TRUCKS, TRACTORS & TRAILERS OWNED, LEASED, HIRED,
RENTED, OR BORROWED WHICH ARE USED BY THE NAME INSURED.
A. Section II - Liability Coverage, Paragraph A.
Coverage, Subparagraph 1. Who is an Insured is
changed to include as an "insured" the person or
organization shown in the SCHEDULE on this
endorsement only if they are liable for the conduct
of an "insured" shown in the Who is an Insured
provisions and only to the extent of that liability.
B. Coverage provided by this endorsement applies to
'auto(s)" described in the SCHEDULE on this
endorsement.
C. The coverage provided by this endorsement ends
when the Additional Insured is not liable for your
conduct or the Policy Expiration Date, whichever
occurs first.
D. The Additional Insured shown in the SCHEDULE
on this endorsement is covered for an amount up
to the Limit of Insurance required in an agreement
with you or the policy's Limit of Insurance,
whichever is less.
CA 49 0104 11 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1
Copyright, Insurance services Office, Inc., 1986
POLICY NUMBER: GWP86978A
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
The provisions of the Coverage Form apply unless modified by this endorsement.
This endorsement changes the policy effective on the inception date of the policy unless another date is
indicated below.
Named Insured
Endorsement Effective
DOUBLESTROKE TRUCKING LLC
MARCH 7 2012
Endorsement Number
GREAT WEST CASUALTY COMPANY
6
FLOOD & PETERSON INSURANCE INC 0560
SCHEDULE
Policy Expiration Date: MAY 23 2012
Name of Person or Organization, (Additional Insured):
CITY OF FORT
PO BOX 580
FORT COLLINS
COLLINS
CO 80522
A. Who is an Insured is changed to include as an C. The Additional Insured is covered for an amount
additional insured the person(s) or organization(s) up to the Limit of Insurance required by an
shown in the SCHEDULE on this endorsement but agreement you have with them or the policy's
only to the extent that the liability arises: Limit of Insurance, whichever is less.
1. In the performance of your ongoing
operations; or
2. In connection with your premises owned by
or rented to you;
and only to the extent that the additional insured is
vicariously liable for your conduct.
B. The coverage provided by this endorsement shall
be subject to all the terms, conditions, and
exclusions of the policy and all endorsements
attached thereto.
D. Any coverage provided by this endorsement is
excess over any other valid and collectible
insurance available to the additional insured
whether primary, excess, contingent, or on any
other basis unless the contract or agreement you
have with them requires that this insurance be
primary.
CG 49 04 07 10 Includes copyrighted material Insurance services Office, Inc. with its permission. Page t of 1
Copyright, Insurance Services Office, Inc., 2004