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HomeMy WebLinkAboutHENRY HERSH TRUCKING INC - INSURANCE CERTIFICATEA 6 A4CC) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) k/31/2017 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 endorsements . Utah -Hub International Transportation Insurance Se CONTAPRODUCER NAME: m ary Ortiz PHONE 800-748-5012 FAX . 866-436-4685 6440 Wasatch Blvd Suite 235 E-MAIL TISCERTREQ anHubinternation al.com INSURERS AFFORDING COVERAGE NAIC # Salt Lake City UT 84121 INSURERA:Northland Insurance Company 24015 INSURED HENRHER-01 INSURER B:The Travelers IndemnityCompany 25658 INSURER C Henry Hersh Trucking, Inc. INSURER D 202 E. Vine Drive Fort Collins CO 80524 INSURER E INSURER F : r ...,�.....�. !`CI?Tu=le-ATIC: R!I1a11GF0, 1`121414r,27 REVISION NLIMBFR: vTHIS 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 INSURANCEADDLISUBRI INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X❑ OCCUR WN220756 6/1/2017 6/1/2018 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $100,000 MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRODUCTS -COMP/OP AGG $2,000,000 X POLICY1:1 PRO-LOC JECT $ OTHER: A AUTOMOBILE LIABILITY VVN220756 6/1/2017 5/1/2018 'LE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ AUTOWNED X SCHEDULED AUTONON-OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR HCLAIMS-MADE DIED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- STATUTE ER E.L. EACH ACCIDENT $ AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYE $ OFFICER/MEMBER EXCLUDED? ❑ (Mandatory In NH) NIA E.L. DISEASE - POLICY LIMIT $ -yes, de , iue under DESCRIPTION OF OPERATIONS below B Motor Truck Cargo QT 660 9472B521-TIL-17 9/14/2017 9/14/2018 Limit $1,000,000 Deduct. $5,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Schedule of vehicles on file with company. Certificate Holder is named Additional Insured (endorsement ordered from company) CERTIFICA I E HULUEK 1 1v 1 City of Fort Collins PO Box 580 Fort Collins CO 80522 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 otg�z�doe�� lJ I Voo-LV IY HliVr�✓ �....1.� �,�..-,. ­. — .U.....,,.,,....,_. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD