HomeMy WebLinkAboutCOLORADO CARRIAGE/ JIM RICE - INSURANCE CERTIFICATEBECKETT JOHN C & ASO
220 SMITH STREET
FT COLLINS, CO 80524
PRWRE-11YEI
CITY FORT COLLINS
PO BOX 580
FORT COLLINS, CO 80522
Additional insured endorsement
Name of Person or Organization
CITY FORT COLLINS
PO BOX 580
FORT COLLINS, CO 80522
Policy number: 03749570-0
Underwritten by:
Artisan and Truckers Casualty Co
Insured: JIM RICE
June 3, 2015
Policy Period: May 28, 2015 - May 28, 2016
Mailing Address
Artisan and Truckers Casualty Co
PO Box 94739
Cleveland, OH 44101
1-800-444-4487
For customer service, 24 hours a day,
7 days a week
The person or organization named above is an insured with respect to such liability coverage as is
afforded by the policy, but this insurance applies to said insured only as a person liable for the conduct of
another insured and then only to the extent of that liability. We also agree with you that insurance
provided by this endorsement will be primary for any power unit specifically described on the
Declarations Page.
Limit of Liability
Bodily Injury
Property Damage
Combined Liability
Not applicable
Not applicable
$300,000 each accident
All other terms, limits and provisions of this policy remain unchanged.
This endorsement applies to Policy Number: 03749570-0
Issued to (Name of Insured): JIM RICE
TAMMY RICE
Effective date of endorsement: 05/28/2015
form 1198 (01i0 )
Policy expiration date: 05/28/2016