HomeMy WebLinkAbout463826 TATONKA CONTRACTORS LLC - INSURANCE CERTIFICATE (2)01, Erie CERTIFICATE OF INSURANCE
lnsurancc - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY -
100 Erie Ins. PI. • Erie, PA 16530 CERTIFICATE HOLDER COPY
NAME AND NUMBER OF AGENCY DATE ISSUED 05/02/2013
THE DECKER AGENCY INC NN1141
37 ELMWOOD AVENUE NAME AND ADDRESS OF CERTIFICATE HOLDER
BUFFALO. NY 14201-201e 716-883-1455
NAME AND ADDRESS OF NAMED INSURED+y,
`T 1J � 0p L" CITY OF FORT COLLINS
TATONKA CONTRACTORS LLC PURCHASING DIVISION
C/O JAMES RITZEL PO BOX 580
1455 QUAIL RUN RD FORT COLLINS CO 80522—
HUDSON CO 80642—
This is to certify that policies, as indicated by Policy Number below, are in force for the Named Insured at the time that the certificate is being issued.
TYPE6EINSURANCE> DDLCY NUNBEq POLICY POLICY tJY71^u OF INSURANCE
EFFECTNE DATE EXPIRATbDI DATE
EACH OCCURRENCE S
FIRE DAMAGE $
--_
(Any one premises)
MEDEXP(Anyoneperson) $
PERSONAL A ADV INJURY $
GENERAL AGGREGATE $
PRODUCTS-COMPIOP AGG S
AUTOMOBILE LIABILITY 0065630120 06/06/2013 06/06/2014 BODILY INJURY $
(EACH PERSON) ,_,......_
OWNED BODILY INJURY $
EACH ACCIDENT) ........
PROPERTY DAMAGE S
BODILY INJURY AND $
1000000 PROPERTY DAMAGE
COMBINED
EACHOCCURRENCE ..............................................................................................................
.......................................................................
AGGREGATE
STATUTORY
BODILY ACCIDENT S EACH ACCIDENT
INJURY DISEASE S POLICY LIMIT
BY DISEASE 5 _ _ EACH EMPLOYEE
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CANCELLATION: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE
DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
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).
THIS CERTIFICATE IS ISSUED FOR INFORMATION PURPOSES ONLY AND
CONFERS NO RIGHTS ON THE CERTIFICATE HOLDER. IT DOES NOT
AFFIRMATIVELY OR NEGATIVELY LIST, AMEND, EXTEND OR OTHERWISE
ALTER THE TERMS, EXCLUSIONS AND CONDITIONS OF INSURANCE
COVERAGE CONTAINED IN THE POLICY(IES) INDICATED ABOVE. THE TERMS
AND CONDITIONS OF THE POLICY(IES) GOVERN THE INSURANCE COVERAGE
AS APPLIED TO ANY GIVEN SITUATION. LIMITS SHOWN MAY HAVE BEEN
REDUCED BY CLAIMS PAID. THIS CERTIFICATE OF INSURANCE DOES NOT
CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
ERIE INSURANCE
SEE REVERSE SIDE
F-156B 09112 CIF
AUTHORIZED l /
REPRESENTATIVE