HomeMy WebLinkAbout581986 ANDERSON CONSTRUCTION COMPANY - INSURANCE CERTIFICATEAllstate.
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CERTIFICATE OF INSURANCE
Cl C W A02 10 11
This certificate is issued for informational purposes only. it certifies that the policies listed in this document have been issued
to the Named Insured. It does not grant any rights to any party nor can it be used, in any way, to modify coverage provided
by such policies. Alteration of this certificate does not change the terms, exclusions or conditions of such policies. Coverage
is subject to the provisions of the policies, including any exclusions or conditions, regardless of the provisions of any other
contract, such as between the certificate holder and the Named Insured. The limits shown below are the limits provided at
the policy inception. Subsequent paid claims may reduce these limits.
Certificate Holder.
CITY OF FORT COLLINS
C/O PURCHASING DIVISION
PO BOX 580
FORT COLLINS, CO USA 805220580
Named Insured:
ANDERSON CONSTRUCTION COMPANY
INCORPORATED
PO BOX 103005
DENVER CO 80250-3005
Automobile Liability
Insurer Name: Allstate Insurance Company
Number: 648735184
1 --Any Auto
2 - Owned Autos Only
3 - Owned Priv. Pass. Autos Only
LPolic
4 -- Owned Autos Other Than Priv.
Pass. Autos OnlyNo
5 - Owned Autos Subject to
Fault
6 - Owned Autos Subject to a Compulsory UM Law
X
7 -- Si)eciticaliv Described Autos
8 - Hired Autos Only
9 - Nonowned Autos Only
Policy Effective Date : 11-15 - 2 017
Policy Expiration Date: l l - I E - 2 018
Limits of
$1, 000, 000
1 Combined Single Limit (each accident)
Insurance:
BI Per Person
I BI Per Accident
PD Per Accident
Description of Operations/Locations/Vehicles/Endorsements/Special Provisions
Interested Party Type: Additional Insured - Municipality
THIS CERTIFICATE DOES NOT GRANT ANY COVERAGE OR RIGHTS TO THE CERTIFICA rE HOLDER.
IF THIS CERTIFICATE INDICATES THAT THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED, THE POLICY(IES) MUST
EITHER BE ENDORSED OR CONTAIN SPECIFIC LANGUAGE PROVIDING THE CERTIFICATE HOLDER WITH ADDITIONAL
INSURED STATUS. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ONLY TO THE EXTENT INDICATED IN SUCH
POLICY LANGUAGE OR ENDORSEMENT.
Producer.
JAMES MICHALKA
Authorized Representative:
Date:09-19-17
Includes copyrighted material of Insurance Services Ottice, Inc., with its permission
�ut,aR s CI CW A02 1011
Allstate Insurance Company
Additional Insured Copy
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Allstate
You're in good hands,
POLICY NUMBER: 648735184
COMMERCIAL AUTO
CA20481013
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED FOR
COVERED AUTOS LIABILITY COVERAGE
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless
modified by this endorsement.
This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage
under the Who is An Insured provision of the Coverage Form. This endorsement does not alter coverage
provided in the Coverage Form.
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated
below.
Named Insured: ANDERSON CONSTRUCTION COMPANY
Endorsement Effective Date: 11-15 - 2 017
SCHEDULE
Name Of Person(s) Or Organization(s):
CITY OF FORT COLLINS
CIO PURCHASING DIVISION
PO BOX 580
FORT COLLINS, CO USA 805220580
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
Each person or organization shown in the Schedule is
an "insured" for Covered Autos Liability Coverage, but
only to the extent that person or organization qualifies
as an "insured" under the Who Is An Insured
provision contained in Paragraph A.1. of Section II —
Covered Autos Liability Coverage in the Business
Auto and Motor Carrier Coverage Forms and
Paragraph D.2. of Section I — Covered Autos
Coverages of the Auto Dealers Coverage Form.
a 1.j --
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1;0&111
BU114R-3 CA 20 48 10 13
Insurance Services Office, Inc., 2011
Additional Insured Copy
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