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Home My WebLink About463897 HENRY HERSH TRUCKING - INSURANCE CERTIFICATE (6)OP ID: SC ,41% R CERTIFICATE OF LIABILITY INSURANCE E(MM/) 7OT9/23/2015 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:970-223-1804 Front Range Insurance Group 1100 Haxton Drive Suite 100 Fax: Fort Collins, CO 80525 David A. Wooldridge LUTCFAAI CONTACT NAME: PHONE FAX A/c No Ext : A/C No): E-MAIL ADDRESS: PRODUCER HENRY-2 CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Henry Hersh Trucking, Inc. 202 E. Vine Dr' Fort Collins, CO 80524 INSURER A: Plnnacol Assurance 41190 INSURER B: Allied Insurance INSURERC: Nationwide Insurance INSURER D : INSURER E: INSURER F : COVERAGES 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. INSR LTR TYPE OF INSURANCE A L POLICY NUMBER POLICY EFF MM/DDrYYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE C! OCCUR EACH OCCURRENCE $ DAMAGE TO RENTEU-- PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRO LOC 17 POLICY 71 FCjAUTOMOBILE PRODUCTS - COMP/OP AGG $ $ B LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ACP7590661575 01/31/2015 01/31/2016 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ X X Comprehensive $ 25 Collision $ 1,00 UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 4070567 07/01/2015 07/01/2016 X I WC STATU- OTH- T RY LIMIT ER E.L. EACH ACCIDENT $ 100,00 E.L. DISEASE - EA EMPLOYEE $ 100,00 E L. DISEASE - POLICY LIMIT $ 500,00 B Property C Flood 1 187-05139203-2013 ACP7500661575 01/31/2015 01/27/2015 01/31/2016 01/27/2016 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Fort Collins Purchasing Division PO Box 580 / 215 N Mason St Fort Collins, CO 80524 L,AN1,rLLA I IUN 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 © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD