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Home My WebLink About495725 STEVE SCHMIDT TRUCKING INC - INSURANCE CERTIFICATE (4)ACORD,� CERTIFICATE OF LIABILITY INSURANCE REVISED DATE ts/2013 ) PRODUCER Serial # 114111 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MACHANN INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 11160 NO. HURON, STE. 36 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. NORTHGLENN, CO 80234 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: ACUITY A MUTUAL INSURANCE COMPANY STEVE SCHMIDT T LICKING, INC. INSURERB: PINNACOL ASSURANCE - P.O. BOX 740 INSURER c: INSURER0: WINDSOR,CO 80550-0704 INSURER E: COVERAGES 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 POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSRL TYPE OF INSURANCE POLICY NUMBER POLICY MMIDOM POLICY MMIDDA) LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR DAMAGE TOR171 PREMISES RENTED $ 100,000 MED EXP (Anyone person) $ 5,000 A L68262 8/29/13 8/29/14 PERSONAL BADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POUCYF_j PRO- JECT OC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ 1,SSS,ODD X BODILY INJURY (Per person) S A ALL OWNED AUTOS SCHEDULED AUTOS L68262 8/29/13 8/29/14 X X BODILY INJURY (Per accident) $ HIREDAUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE S RETENTION IS B WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERJEXECUTIVE OFFICERIMEMBEREXCLUDED? It yes, describe under SPECIAL PROVISIONS below 4051302 1/1/13 1/1/14 X WC STATU- OTH- TONY LIMITS ER EL EACH ACCIDENT $ 500,000 EL DISEASE - EA EMPLOYEE I 8 500,000 EL DISEASE -POLICY LIMIT IS 500,000 OTHER LIMIT: $10,000 A MOTOR TRUCK CARGO L68262 ..................................... 8/29/13 ..................... 8/29/14 ..................... DEDUCTIBLE: $500 DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CERTIFICATE HOLDER IS AN ADDITIONAL INSUREDS PER ATTACHED CG 2010 (7-04) ON THE GENERAL LIABILITY. ADDITIONAL INSURED STATUS INCLUDES AUTOMOBILE LIABILITY. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION PURCHASING DEEPT.PT. CITY OF FORTCOLLINS DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL P.O. BOX 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR FT. COLLINS, CO 80522-0580 FAX: 970-221-6707 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001108) 0 ACORD CORPORATION 1988