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Home My WebLink About106089 WESTERN STATES LAND SERVICES INC - INSURANCE CERTIFICATE (4)WESTSTA-01 MTIJERINA ACORO CERTIFICATE OF LIABILITY INSURANCE DATE (21120Y 1111 /206 16 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 have ADDITIONAL INSURED provisions or 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 CONTACT NAME: Richards, Seeley & Schaefer, Inc. PHONE FAx 3640 W.112th Ave. Svc, No, Ext): (303 ) 429-3561 ac, No : ( 303) 427-0611 Westminster, CO 80031 E-M R'Ess: certs@rss-insurance.com INSURED Western States Land Services Phil Mazure 505 N Denver Ave Loveland, CO 80537 INSURER F : rr1VCDAf_CC r`C0TI1=1f ATF NIIIu1RFR- RFVI-RlnN 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP yYYYi LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR BZW57495209 12115/2016 12/15/2017 EACH OCCURRENCE $ 2,000,000 DAMAGE TSESO RENToccED n 2,000,000 MED EXP (Any oneperson) 15,000 PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY F] j LOC OTHER: GENERAL AGGREGATE 4,000,000 PRODUCTS - COMP/OP AGG B AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY AUOTOS ONLY 834242-20 01/30/2017 01/30/2018 COMBINED SINGLE LIMIT i n 11000,000 BODILY INJURY Perperson) BODILY INJURY Per accident f20PERTY AMAGE Fer accident UMBRELLA LIAB EXCESS LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE DIED I RETENTION$ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN N ANY PROPRIETOR/PARTNER/EXECUTIVE FICER/MEMBEREXCLUDE[ ? W100,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 1803222 01/01/2017 I 01/0112018 I PERUTE ORH- E.L. EACH ACCIDENT 100,000 E.L. DISEASE - EA EMPLOYE E.L. DISEASE - POLICY LIMIT 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Ft Collins are included as additional insureds by contract. City of Ft. Collins Purchasing Department PO Box 580 Ft. Collins, CO 80522-0580 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 (2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD