HomeMy WebLinkAboutCORRESPONDENCE - BID - 7355 HAULING SERVICESNonowned Autos
U-201 Ed. 5/00
Damage to Premises Rented to You
Hired Auto
Scheduled Autos
All Owned Autos
Any Auto
(Mo, Day, Yr) (Mo, Day, Yr)
Aggregate Limit
Automobile Liability
Businessowners Liability
General Liability
Workers Compensation and
Employers Liability †
Farm/Ranch Liability
Boatowners Liability
Personal Umbrella Liability
Should any of the above described policies be cancelled before the
expiration date thereof, the company will endeavor to mail *( days)
written notice to the Certificate Holder named, but failure to mail such
notice shall impose no obligation or liability of any kind upon the
company, its agents or representatives. *10 days unless different
number of days shown.
described policies are subject to cancellation in conformity with their
terms and by the laws of the state of issue.
CERTIFICATE OF LIABILITY INSURANCE
Each Occurrence
Bodily Injury and Property Damage
Bodily Injury and Property Damage
Each Occurrence
Bodily Injury and Property Damage
Each Occurrence
Farm Liability & Personal Liability
Each Occurrence
Farm Employer’s Liability
Products - Completed Operations Aggregate
Each Occurrence†
Commercial Blanket Excess
Medical Expense (Any One Person)
Commercial General
Liability (occurrence)
•
COVERAGES
TYPE OF INSURANCE LIMITS OF LIABILITY
$
$
$
$
$
$
$
$
$
$ ,000
,000
,000
,000
,000
,000
,000
,000
,000
,000
,000
,000
,000
,000
,000
Each Occurrence
Personal and Advertising Injury
General Aggregate
Disease - Policy Limit
Disease - Each Employee
Statutory
Each Accident
$
$
$
$
$
$
,000
The individual or partners shown as insured Have Have not
elected to be covered as employees under this policy.
†
† †
,000
,000
************
†
This is to certify that 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.
This certificate is issued as a matter of information only and confers no rights upon the Certificate Holder.
DATE ISSUED AUTHORIZED REPRESENTATIVE
This certifies coverage on the date of issue only. The above
$ ,000
Bodily Injury - Each Accident
Bodily Injury - Each Person
$
$
,000
,000
POLICY NUMBER EFFECTIVE EXPIRATION
Homeowners/
Mobilehomeowners Liability
American Family Insurance Company
6000 American Pky Madison, Wisconsin 53783-0001
American Family Mutual Insurance Company if selection box is not checked.
Aggregate††
Common Cause Limit $
$
Property Damage $ ,000
Bodily Injury and Property Damage Combined
This certificate does not amend, extend or alter the coverage afforded by the policies listed below.
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / RESTRICTIONS / SPECIAL ITEMS
Each Occurrence/Aggregate $ ,000
Liquor Liability
Excess Liability
CERTIFICATE HOLDER’S NAME AND ADDRESS
Products-Completed Operations aggregate is equal to each
occurrence limit and is included in policy aggregate.
CANCELLATION
Other (Miscellaneous Coverages)
POLICY DATE
Insured’s Name and Address Agent’s Name, Address and Phone Number (Agt./Dist.)
Robert Stilo
PO Box 358
Loveland, CO 80539
Roy A Christman (970) 669-0007
1402 W 28th St Ste 1
Loveland, CO 80538-3169 (157/309)
Each Occurrence
✘ General Liability 1870-4392-01-63-CO 2/21/2014 2/21/2015
250
250
500
✘ 1870-4392-01-63-CO 2/21/2014 2/21/2015
250
500
250
City of Fort Collins
PO Box 580
Fort Collins, CO 80522
221 6707 ✘
2/17/2014 Roy Christman Agent
Stock No. 06668 Rev. 7/02