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HomeMy WebLinkAbout112297 VINEY TRUCKING INC - INSURANCE CERTIFICATE (16)UP IU: 1 ACORO' CERTIFICATE OF LIABILITY INSURANCE OATE(MM/031 2013 V) `.� 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 endorsements). PRODUCER PFS Insurance Group -JT $848 Thompson Pkwy, Ste 200 Johnstown, CO 80534 INSURED Viney Trucking,ln( P.O. Box 1446 LaPorte, CO 80535 Phone: Fax: INSURER C Pinnacol Assurance COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 1190 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. INSR ADDL'SUBR POLICY EFF POLICVEXP LTR TYPE OF INSURANCE I POLICY NUMBER MMIDD/YYYY MMIDO(YYYY LIMITS GENERAL LIABILITY C COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR NIA EACH OCCURRENCE DAMAGE TO RENTED PREMISES_{ Ea occurrence)_ MED EXP (Any one person) $ $ $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO 1 LOG PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS N/A COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident $ $ S LIAR EXCESS LIAR OCCUR CLAIMS -MADE N/A EACH OCCURRENCE $ HUMBRELLA AGGREGATE $ RDEDUCTIBLE D RETENTION $ 8 $ A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION under If yes. DESCRIPTION OFF OPERATIONS below NIA 1963162 T BLNT WAIVER OF SUBROGAO 06/01/2012 06/01/2013 IE. X WC STATU- OTH- TORV_LIMIT$ ER E.L. EACH ACCIDENT $ 100,00 E.L. DISEASE - EA EMPLOYEES 100,000 L. DISEASE - POLICY LIMIT $ 500,000 05/20/2001 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION CITYFCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CITY OF FORT COLLINS P O Box 580 AUTHORIZED REPRESENTATIVE FORT COLLINS, CO 80521 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD