The URL can be used to link to this page

Home My WebLink About498970 HILL ENTERPRISES INC DBA HILL PETROLEUM - INSURANCE CERTIFICATE (3)HILLE-3 OP ID: VM A41% " CERTIFICATE OF LIABILITY INSURANCE DATE 6/201 YY) os/os/zola 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 PFS Insurance Group - DV 7200 S Alton Way, Ste A-140 Centennial, CO 80112 Mark Polk CONTACT PHONE FAX AIC N_0 EXt): MC Nei: E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC N INSURER A: Nationwide Agribusiness IDS CO 28223 V INSURED Hill Enterprises, Inc., DBA INSURER 8: Pinnacol Assurance Co 41190 Hill Petroleum 6301 Ralston Road INSURERC: INSURER D: Arvada, CO 80002 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: RFVISION NIIMRFR- 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 ADOLTSUB I POLICY NUMBER POLICY EFF MMIDONYYVI POLICY EXP (MMIDD[YYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY FvI CLAIMS -MADE i OCCUR CPP104980A 10/01/2013 10/01/2014 DAMAGE TORENTED PREMISES Ea0.unence $ 100,00 MED EXP (Any one person) $ 5,00 X Blkt Add'I Ins'd PERSONAL S ADV INJURY $ 1,000,00 X Blkt Wvr of Sub GENERAL AGGREGATE $ 2,000,00 GEHL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,0010 POLICY 7 PRO LOC $ AUTOMOBILE LIABILITY EOMeBINREeDrSINGLE LIMIT $ 1,000,00 X BODILY INJURY (Per person) $ A ANY AUTO CPP104980A 10/01/2013 10/01/2014 ALL OS SCHEDULED AUTOS AUTOA BODILY INJURY Per aWdenl ( I $ HIRED AUTOS X NON -OWNED AUTOS X (PER ACTYDAMAGE PER ACCIDENT $ X MCS90 $ BlktAI X BIktWOS X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,00 AGGREGATE $ 5,000,00 A EXCESS LIAR CLAIMS -MADE CU104980A 10/01/2013 10/01/2014 DED J I RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? EJ (Mandatory in NH) If yes, desuibe urde, DESCRIPTION OF OPERATIONS below NIA 4148287 BLKTWOS 06/01/2014 06/01/2015 WC STATU- OTH- TORY LIMITS X R E.L. EACH ACCIDENT $ 500,00 E.L. DISEASE EA EMPLOYEE $ 500,00 E.L. DISEASE - POLICY LIMIT $ 500,00 A Property COP104980A 10/01/2013 10/01/2014 Buildings 11,053,91 Ded $6,000 BPP 500,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ANaah ACORD 101, Additional Rsmarks Sch.duls, If mon space le roqulrod) If required by written agreement, the certificate holder is included as additional insured for ongoing operations under general liability and designated insured under automobile liability (except hired and non -owned automobile). CITYFCI City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATWE 1d w-�+s (J 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD