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HomeMy WebLinkAbout384033 J J'S TRUCKING - INSURANCE CERTIFICATE (16)3/27/2015 3:43 PM FROM: Fax John C Beckett and Associates TO: 2246134 PAGE: 001 OF 001 ACOROCERTIFICATE OF LIABILITY INSURANCE DATE 03/273/27/20152015 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 JOHN C. BECKETT 6 ASSOCIATES, INC. 220 Smith Street Ft. Collins CO 80524- CONTACT NAME: PHONE (970) 484-2805 1 AIC No: (970) 484-28e5 r MA -A RESS tim@beckettinsurance.com INSURERS AFFORDING COVERAGE NAIC f INSURERA:PINNACOL ASSURANCE CO. INSURED Stan Pflipsen DBA TJ, s Trucking 221 W. Douglas Road #17 Fort Collins CO 80524- INSURERB: INSURERC: INSURER D INSURER E INSURER 17"VFw A"FN CFRTI FI('ATF u11MRFR. RGVI cinu lull laa0co. 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. LTR TYPE OF INSURANCE ADDLISLOR POLICY NIBABER MMIDDf EFF MMIMIYVXYY LIMITS GENERAL LIABILITY NO COVERAGE / / / / EACH OCCURRENCE $ COMMERCIAL GENERAL LLABILITY CLAIMS -MADE OCCUR / / / / / / / / tNItU PR MISS occurrence $ MED EXP (Any oneperson) $ PERSONAL B ADV INJUR Y $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ / / / / POLICY F1 PRO- LOC / / I I $ AUTOMOBILE LIABILITY O COVERAGE Ea accident BODILY INJURY (Per person) $ ANY AUTO / / / / TOALL OK JED SACUTOEDULED / / / / BODILY INJURY (Per axideM) $ NON-ONMED HIRED AUTOS AUTOS / / / / PROPS TY AMAG (Per accident)$ $ / / / / UMBRELLA LIAB OCCUR O COVERAGE / / / / EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE / / / / DED RETENTION A WORKERS COMPENSATION 154652 4/01/2015 4/01/2016 X VIC STATU- OTH- AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE a OFFICERRAEMBER EXCLUDED? (Mondadory In NH) NIA / / / / / / / / E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYE $ 500,000 If s, describe under DE SCRIPTION OF OPERATIONS below / / / / E.L. DISEASE -POLICY LIMIT $ 100,000 DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) ( ) - (970) 224-6134 PURCHASING DEPT CITY OF FORT COLLINS 215 N IFMSON 2ND FLOOR FORT COLLINS CO 80522-0580 i i v" 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 REPRESENTATIVE ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. INS025 (201005)01 The ACORD name and logo are registered marks of ACORD