HomeMy WebLinkAbout564723 ALL-OUT TRUCKING INC - INSURANCE CERTIFICATEALLOUTT OP ID: ALS
,4COR 6 -
�„_� CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
02I01/2019
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 endorsement(s).
PRODUCER Phone: 303-430-5725
NAME: CONTACT
Truckers' Equity Agency, Inc.
PO Box 417 Fax: 303-430-7698
Wheat Ridge, CO 80034-0417
Julie A McBee
PHONE FAX
c No, Extl: _ I((A/c No):
ADDRESS: --
INSURER S AFFORDING COVERAGE
NAIC #
_
INSURER A: Wilshire Insurance Company
_
INSURED All -Out Trucking Inc
INSURER B :
40590 Leif Ln
Ault, CO 80610
INSURER c
INSURER D :
INSURER E :
INSURER F :
COVFRAGFR 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.
TYPE OF INSURANCE
ADDL
SUB
POLICY NUMBER
MM/DDYYYY
MMLDD YYYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
rA
X COMMERCIAL GENERAL LIABILITY
X
BA2605696
01/21/2019
01/21/2020
NIAGE T RENTED
PREMISES Ea occurrence
$ 100,00
MED EXP (Any one person)
$ 5,00
CLAIMS -MADE OCCUR
i
PERSONAL i3ADVINJURY
$ 1,000,00
GENERAL AGGREGATE
$ 2,000,00
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS -COMP/OP AGG
$ 1,000,000
$
X POLICY PRO LOC
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
11000,000
BODILY INJURY (Per person)
$
A
ANY AUTO
X
BA2605696
01/21/2019
01/21/2020
BODILY INJURY (Per accident)
$
ALL OWNED X SCHEDULED
AUTOS AUTOS
NON -OWNED
HIRED AUTOS AUTOS
DAMAGE
PROaccident) PROPERTY
(Per
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
WC STATU- OTH-
TCRYIMI I ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
OFFICER/MEMBER EXCLUDED? ❑
(Mandatory in NH)
N / A
E.L. DISEASE - POLICY LIMIT
1 $
If yes, describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
endorsement naming certificate holder as additional insured has been
requested from company
TE HOLDER
City of Fort Collins
Purchasing Dept
PO Box 580
Ft. Collins, CO 80522
CITYFOR
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
V 1Udd-ZU9U AL UKLJ I,UKYVKA 1 IUPI. All rigrub rebvrveu.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD