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Home My WebLink AboutDOUBLESTROKE TRUCKING LLC - INSURANCE CERTIFICATE (4)Client#: 51490 DOUTR ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE 0/201/YVYV) s11 o/zD1 z 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 CONTACT Beth Isakson NAME: Flood & Peterson Ins., Inc. a�NN Ezt: 970 356-0123 FAX Net: 970 506-6850 P. O. Box 578 aooaiess: beth.isakson@floodandpeterson.com Greeley, CO 80632 PR Du ER 970 356-0123 CUSTOMER ID #: INSURERS) AFFORDING COVERAGE NAIC# INSURED INSURER A: Great West Casualty Doublestroke Trucking LLC 1200 Crest Ct INSURER B : Windsor, CO 80550 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 FORTH E 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 %DDLSUBR NSR AVE POLICY NUMBER POLICY SEE MM/DD/YYYV POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS-MADEAj OCCUR GWP869786 5/23/2012 05/23/2012 EACH OCCURRENCE $1 000000 DAMAGE TO RENTED PREMISES(Eaoccurrenee $100000 MED EXP(Any one person) $5,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY r PRO LOG IFCT• PRODUCTS-COMP/OPAGG $2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GWP869788 5/23/2012 05/2312011 COMBINED SINGLE LIMIT (Ea decide") $1000000 BODILY INJURY (Per person) S BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ X X $ S LA LIAB LIAB F OGGUR EACHOCCURRENCE $ AGGREGATE $ IBLE ION $ $ WORKERS COMPENSATION ANOEMPLOYERS'LIABILITY Y/N ANY PROPRIETO W PARTNE WEXECUTIVE OFFI GERIMEMBER EXCLUDED? (Mandatory in NH) If yes, descnbe under DESCRIPTION OF OPERATIONS below N/A - WC BTATU- OTHBE I BE E.L. EACH ACCIDENT $ EL. DISEASE EA EMPLOYEE $ EL. DISEASE POLICY LIMIT $ A Broad Form Cargo GWP869786 5/23/2012 05/23/2013 $10,000 Per Unit $1,000 Deductible DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ADDED 101, Additional Remarks Schedule, it more space is required) City of Fort Collins is listed as an Additional Insured in regards to the General Liability and Auto Liability. City of Fort Collins Attn: Purchasing 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 (2009/09) 1 Of 1 #SG95528/M695523 - - The ACORD name and logo are registered marks of ACORD MLU