HomeMy WebLinkAboutHAMILTON ELECTRIC CONSTRUCTION - INSURANCE CERTIFICATETHIS 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_.
CO TYPE OF INSURANCE POLICY NUMBER 1 POLICY DATE (MM1DbEFFECTIV1YYE, PpATE IMryyPIpRpA PION _ LIMITS
LTR
GENERAL
LIABILITY
GENERAL AGGREGATE
S 2 OOO OOO
COMMERCIAL GENERAL LIABILITY
I
PRODUCTS - COMPlOP AGG
S 2,000,000
A
CLAIMS MADE X OCCUR
9809933
01/01/08
01/01/09
PERSONAL & A D V INJURY
s, 1,000,000—
.........
OWNER'S & CONTRACTOR'S PROT
EACH OCCURRENCE
S 1,0001000
X
BUSINESSOWNEA'S POLICY
_
.. ..
FIRE DAMAGE IAny one tire)
_. ..
$ 50,000
MED EXP (Any one person)
S
AUTOMOBILE LIABILITY 1,000,000
X ANY AUTO COMBINED SINGLE LIMIT S
_ _..................-- . ......_.
ALL OWNED AUTOS
--- BODILY INJURY 5
A SCHEDULED AUTOS 9809934 01/01/08 01/01/09 (Per person)
X HIRED AUTOS
BODILY INJURY S
X NON -OWNED AUTOS (Per acddenO
PROPERTY DAMAGE
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
S
OTHER THAN AUTO ONLY:
ANY AUTO
EACH ACCIDENT-------------
S
AGGREGATE
$
EXCESS LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
X UMBRELLA FORM
9809935
01/01/08
01/01/09
AGGREGATE _
$ 1 r.0001000
OTHER THAN UMBRELLA FORM
$
WORKERS COMPENSATION AND
WC STATU - OTH-
X TORY LIMB'S ER
EMPLOYERS' LIABILITY
..___._..._..._ ._._........._
EACH
_.._,.__.--_..___..__...._._._....
A
THE PROPRIFTOR/ I WCL
9809936
01/01/08
01 /0 I /09
..EL ,ACCIDENT ,__.___..._...__...$500,000-
£L ISEASE -POLICY LIMIT
D
S SOO 000
PARTNERS/EXECUTIVE ..._.
_._�—.._._._�...__..........._.__....__.......__._..__...t___..._._.__...
OFFICERS ARE: EXCL
EL DISEASE - EA EMPLOYEE
$ 500,000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/SPECIAL ITEMS
alalsaa CITY OF FT COLLINS
PO BOX 580
FT COLLINS CO 80522-0580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
Of ANY KIND UPON THE COMP , ITS AGE TS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIV ,/2 ,/ ,
Federated Mutual Insurance Company. Federated Service Insurance Company
P.O. Box 328
CST 801 Owatonna, MN 55060
Certificateholder
CITY OF FT COLLINS
PO BOX 580
FT COLLINS CO 80522-0580
Insured
319-195-4 9 HAMILTON ELECTRIC CONSTRUCTION
COMPANY
10855 IRMA DR
NORTHGLENN CO 80233
CANCELLATION NOTICE
CANCELLATION of each policy listed below was requested by the insured.
We will continue to protect your interest as a mortgagee, Certificateholder, additional insured, or loss payee
through the date and time of day shown below.
Policy
Number
Coverage
9809933
BUSINESS OWNERS PACKAGE
9809934
COMMERCIAL PACKAGE POLICY
9809935
UMBRELLA
9809936
WORKERS COMPENSATION
Standard time at the designated business premises.
This Notice was mailed on January 28, 2009.
Policy
Certificateholder
Time of
Cancellation
Cancellation
Policy
Date
Date
Cancellation
01/01/09
01/01/09
12:01 A.M.
01/01/09
01/01/09
12:01 A.M.
01/01/09
01/01/09
12:01 A.M.
01/01/09
01/01/09
12:01 A. M.
MFO.40 (11-92 C)
Federated Mutual Insurance Company. Federated Service Insurance Company
P.O. Box 328
CST 801 Owatonna, MN 55060
Certificateholder
CITY OF FT COLLINS
PO BOX 580
FT COLLINS CO 80522-0580
Insured
319-195-4 9 HAMILTON ELECTRIC CONSTRUCTION
COMPANY
10855 IRMA DR
NORTHGLENN CO 80233
CANCELLATION NOTICE
CANCELLATION of each policy listed below was requested by the insured.
We will continue to protect your interest as a mortgagee, Certificateholder, additional insured, or loss payee
through the date and time of day shown below.
Policy
Number
Coverage
9809933
BUSINESS OWNERS PACKAGE
9809934
COMMERCIAL PACKAGE POLICY
9809935
UMBRELLA
9809936
WORKERS COMPENSATION
Standard time at the designated business premises.
This Notice was mailed on January 28, 2009.
Policy
Certificateholder
Time of
Cancellation
Cancellation
Policy
Date
Date
Cancellation
01/01/09
01/01/09
12:01 A.M.
01/01/09
01/01/09
12:01 A.M.
01/01/09
01/01/09
12:01 A.M.
01/01/09
01/01/09
12:01 A. M.
MFO.40 (11-92 C)