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Home My WebLink AboutDOUBLESTROKE TRUCKING LLC - INSURANCE CERTIFICATE (2)ClientA: 51490 DOUTR ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDNYYY) 5/10/2012 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 NAME: Beth Isakson Flood & Peterson Ins., Inc. PHONE g70 356-0123 970 506-6850 El A/ ANo Ea : A/C, No P. O. Box 578 ADDRESS: Greeley, CO 80632 970 356-0123 CUSTOMER ID e: INSURER(S) AFFORDING COVERAGE NAIC if 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 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. I LTR TYPE OF INSURANCE AnwoPOLICYNUMBER IPOLICY EFF MM/DDNYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY GWP86978B �OS/23/2012 05/23/2013 EACH OCCURRENCE $1 OOOOOO X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $100,000 MED EXP (Anyone person) $5,000 CLAIMS -MADE 51OCCUR PERSONAL&ADV INJURY $1,000,000 GENERALAGGREGATE s2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OPAGG s2,000,000 POLICY M PRO- LOD $ A AUTOMOBILE LIABILITY ANY AUTO GWP86978B 5/23/2012 05/23/2013 COMBINED SINGLE LIMIT (Ea accident) $11000,000 BODILY INJURY (Per person) S ALL OWNED AUTOS X BODILY INJURY (Per accident) S SCHEDULED AUTOS X PROPERTY DAMAGE (Per accident) $ HIRED AUTOS X $ NON -OWNED AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE S EXCESS LIAR CLAIMS -MADE DEDUCTIBLE $ g RF_TENTION S AND KERS EMPLOYCOMPENSATIONRS'LIILIT ANDEMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? WA WC STAT IT OTH- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) D YeS, descride under DESCRIPTION OF OPERATIONS below. E.L. DISEASE -POLICY LIMIT $ A Broad Form Cargo GWP86978B '05/23/2012 05/23/201 $10,000 Per Unit $1 000 Deductible DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if 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 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn: Purchasin THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 580 9 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522 1 AUTHORIZED REPRESENTATIVE (01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of y' The ACORD name and logo are registered marks of ACORD - #S695528/M695523 MLU