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Home My WebLink About107125 BIVENS TRUCKING & EXCAVATING - INSURANCE CERTIFICATE (3)OP ID: JA ,a`oizo CERTIFICATE OF LIABILITY INSURANCE DATEOlYYYY) o1/v02ozna 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 970-223.1804 VolkBell Property & Casualty 1100 Haxton Dr. Suite #100 Fort Collins, CO 80525 Kyle $ RehmB CONTACT PHONE FAX A/c No: E-MAIL PRODUCER CUSTOMER Ior.BIVEN-1 INSURERS AFFORDING COVERAGE NAIC0 INSURED Bivens Trucking & Excavating �� 2 Aaron Bivens 862 W. Willox Ln. Ft Collins, CO 80524 INSURERA: Secure Insurance Companies 22543 INSURERS: Pinnacol Assurance 41190 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 TYPE OF INSURANCE POLICY NUMBER DCY EFF POLICY M Y EXP LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FRI OCCUR X CP3145113 12/15/13 12115/1a EACH OCCURRENCE 1 1,000,0 PREMISES Eaoceunenu S 10010 MED EXP (Any one arson S 10,00 PERSONAL &ADV INJURY S 1,000,00 GENERAL AGGREGATE S 2,000,00 GENL AGGREGATE X POLICY LIMIT APPLIES PER: PRa LOC PRODUCTS -COMPIOP AGO S 2,000,0 S A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS A3145114 12/16/13 12/15/14 COMBINED SINGLE LIMIT (Ea accident) S 1,000,0 X BODILY INJURY (Per person) / BODILY INJURY (Pew accident) S PROPERTY DAMAGE (Per accident) S S S UMBRELLA LAS EXCESS LIAR OCCUR CLAIMS4AADE EACH OCCURRENCE S AGGREGATE 1 DEDUCTIBLE RETENTION $ f B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? ❑ (Mandatory in NH) If yes. describe under DESCRIPTION OF OPERATIONS baloN NIA 3241983 08101113 08/01/14 X WC STATU- OTH- TORY LIMITS ER EL EACH ACCIDENT S 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE -POLICY LIMIT J S 1,000,00 A A Property, Equipment CP3145113 CP3145113 12/15113 12/15113 12115114 12115114 BPP 50,00 Lsd & Rnt 100,00 DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is required) City of Fort Collins is nSena d as additional insured. CERTIFICATE HOLDER CANCELLATION CITY OF 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 PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD