HomeMy WebLinkAbout122133 HILGENBERG EXCAVATING INC - INSURANCE CERTIFICATE (4)HILGE4 OF ID: 1C
CERTIFICATE OF LIABILITY INSURANCE
°TR 05//9114
06/19/14
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(Sh AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: N the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. II SUBROGATION IS WANED, 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:970482-7747
Broom d Brown Inc Fax: 970-484-4165
Fort Boardwalk Or, Suite 200
Fort Collins, CO 80526
House Account
33
CONTACT
NAME:
PMGMK F
WC,,"* (AIC No):
ADDRESS:
eIEURERS AFFORDINGCOVERAGE NAIL.
INSYRERA:Ohlo Security Insurance Co. 24082
INSURED Hilgenberg Excavating, Inc.
2011 Hyllne Dr
Fort Collins, CO 80526
RIMlnsea:Colorado Casualty Ins Co 41785
INsuRmhc:
INSURERD:
INSURER E :
INSURER F: I
COVERAGES CERTIFICATE NUMBER RFVISInNMHMRFR-
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 NAVE BEEN REDUCED BY PAID CLAIMS.
ILTH NS
TYPE OF INSURANCE
POLICY NUYadI
N LJO 8FP
YPY pIYYYPY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS.MADE 1K OCCUR
I
SKS1585455454
M02114
06M2119
EACH OCCURRENCE
3 1.000,00
PRMN0 19, ��ffenwl
3 300,00
MED EXP (Any cm pmen)$
15,00
PERSONAL A ADV INJURY
3 --- 1.000,00(
GENERAL AGGREGATE
f 2,000,00(
GEN'L AGGREGATE
POLICY
LIMIT APPLES PER.
7 PRO-
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PRODUCTS. COMPIOP AGO
$ 2,000,00(
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UMBRELLA
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WORKERS COMPENSATION
AND EMPLOYFAS' LIABILITY
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DESCRIPTION OF OPERATIONS 1 LOCAMN31 VEHICLES (APACA ACORD 101, oMNLI PMI Rm 65 Schedule, IS P.C.sIs mw d)
See Notes:
FTCPOLD
FL 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.
ACORD CORPORATION_ All dnhb
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
(NOTEPAD HILGE-1 ma 2
RIaUREIM NMIE Hilgenberg Excavadng, Inc. OP ID: 1C DATE 06119114
required by written contract the following applies:
ket Additional Insured - Ongoing - CG8810 04/13
ary and Non -Contributory - CG8810 04/13
ketWaiver of Subrogation - CG8810 04/13
Project Aggregate - C08670 12/08
Location Aggregate - CG8860 12/08