HomeMy WebLinkAbout122133 HILGENBERG EXCAVATING INC - INSURANCE CERTIFICATE (3)HILGE-1 OF ID: P6
'4`� CERTIFICATE OF LIABILITY INSURANCE
DAT06106DIYYYY)
06/06/13
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 . Phone: 970-482-7747
Brown & Brown Inc Fax: 970�84�165
4532 Boardwalk Dr, Suite 200
CONTACT
PRONFAX
ac NEo Exl : ac No:
Fort Collins, CO 80625
House Account
E-MAIL
ADDRESS:
�l
INSURERS AFFORDING COVERAGE
NAIC N
INSURER A: Ohio Security Insurance Co.
24082
INSURED Hilgenberg Excavating, Inc.
INSURER B: Colorado Casualty Ins CO
41785
2011 Hyline Dr
Fort Collins, CO 80526
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.
INSR
LTR
TYPE OF INSURANCE
A �b
B
POLICY NUMBER
POLICY EFF
IMMIDDNYYYI
POLICY EXP
IMMIDDNYYYILIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
BKS1465455454
06/02/13
06/02114
EACH OCCURRENCE
E 1,000,00
DAMA E R NTED
PREMISES Ed occurrence
$ 300,00
MED EXP(Any one person)
E 15,00
PERSONAL B ADV INJURY
E 1,000,0001
GENERAL AGGREGATE
E 2,000,00
GEML AGGREGATE L 'MITAPPLIES PER:
POLICY PRO LOC
PRODUCTS - COMP/OP AGG
E 2,000,00
E
B
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED X SCHEDULED
AUTOS AUTOS
HIREDAUTOS X NON -OWNED
AUTOS
BA8635979
06102/13
06102114
Es accident) SINGLE LIMIT
Bt
E 1,000,00
BODILY INJURY (Per person)
E
BODILY INJURY (Par acu)
tlant
E
X
PROPERTY DAMAGE
Per amdent
E
E
UMBRELLA LIAR
EXCESS LUA
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
E
Ll
AGGREGATE
E
DED I I RETENTION E
E
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERJMEMBER EXCLUDED? ❑
(Mandatory In NMI
I1 yea, describe under
DESCRIPTION OF OPERATIONS below
N / A
I WC STATU- OTM-
TORY
E.L. EACH ACCIDENT
E
E.L. DISEASE - EA EMPLOYEEI
E
E.L. DISEASE -POLICY LIMIT 1
E
DESCRIPTION OF OPERATIONS / LOCATIONS) VEHICLES (Attach ACORD 101, ACdlUonal Ramada Schedule, I1 more space Is rerlulnitl)
See Notes:
FTCPOLD
Ft. Collins Police Department
300 LaPorte Avenue
Fort Collins, CO 80524
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORU:ED REPRESENTATIVE
01988-2010 ACORD CORPORATION_ All rinhbe n...r nd
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD