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From: Shana Phillips At: Hix Insurance Associates, Inc. FaxlD: To: Joyce Amundson Date: 10/21/05 11:57 AM Page: 1 of 1 . DATE (MMIDDIYYYY) ACORD. CERTIFICA TE OF LIABILITY INSURANCE OP 10 s4 OGILV-1 10/21/05 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONL Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE Hix Insurance Associates, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 4440 Arapahoe Ave. , Ste 100 AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW. -- Boulder CO 80303 I INSURERS AFFORDING COVERAGE Phone: 303-444-4666 li'ax:303-444-8481 SAle · INSURED ----- ------ I INSURER A. American Alternative :Insurance -- ~-- -- ---~ , II'ISURER B' I 01il~Irriqatinq & Land CO. I~ INSURER C ~_u .---..-_.- C 0 oKce Amundson 822 7t street3 Suite 760 I~SURER D ~--------- --- -- -~._-,-_._--. Greeley CO 806 1 I INSURER E ------ ~._-- .. COVERAGES THE POLICIES OF II,SURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. N01WITHSTAI~DII.I(; ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WIlH RESPECT TO WHICH THIS CERTIFICATE M,o,y BE ISSUED 01" MAY PERT,~.IN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CCNDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWloJ MAY HAVE BEEN REDUCED BY PAID CLAIMS '''~" ~~R~ --~--_.--- LTR TYPE OF INSURANCE POLICY NUMBER DATE (MMIODIYY) 'DATE! (MM/DDIYY) LIMITS GENERAL L1AB1LrTY EACH OCCURRE~ICE '$1,000,000 ~1:~~MERCIAL GENER~I~BILlTY --- A SDISSK91003212 06/01/05 06/01/06 1~~~:SES(E",'ccll~~nc.i '11,000,000 1-" _._____ _____ _____n... - -- ---,--- ---- ,-. I L-!.-J CLAIM'~' MAUt. ~ OCCUR I j MED E),.r~ (.'1ny one person) ! ~ 10 ,000 ------t.-~-- I T PERSONAL & P.f)V II.JJUPY : :~ 1,000,000 IX D&O/EPLI r GENERAL AGGREGATE f.3,000,000 GEN'L ;\GGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG '$3,000,000 h P~L ~Y n PRO- nLOC Emp Ben. 1,000,000 U If..- JEeT , AUTOMOBILE LIABILITY I f-- I COMBII':IED SINGLE L1lv!!T $ ANY AUTO I (Ea accl(ienl) ----- ,.." ALL OWNED AUTOS ~ BODIL '/ II,JUR'( - , :1, SCHEDULED AUTOS (Per person) -- HIRED AUTOS I BODIL Y .INJURY I, - - "ON-OWNED AUTOS ! (Per aCCIdent) I .___m_n._~_ .. I PROPERTY DAM,o,GE ; (Per aCCident) :$ ~ GARAGE L1ABILrTY AUTO or~L Y - EA AC C I DEI'.IT I $ '~ANY AU10 ...n OTHER THAN EA, ACe i$ -~ AUTO OI'~LY #;1:;- i :f. EXCESS/UMBRELLA LIABILITY ! EA.CH OCCURRE[\JCT .$ =:J OCCUR D CLAIMS MADE I A':'GREGATE ---~---- i ~_~________ :$ ! f. ..---- =1 DEDUCTIBLE I I I ..- RETEr,TION $ ::1 WORKERS COMPENSATION AND T ;v'~ ~'hlLr I ILl -: TORY LIMITS ER ' EMPLOYERS' L1ABILrTY I'~--~-'----'~ ANY PROPRIETOR/PARTI.IER/EXECUTIVE EL. EACH ACCIDEIoIT i '~ -- n .. ...... ---. - i OFFICERnvlEMBER EXCLUDED? ! F I DISEASE - FA. EtvlPI r)YF.T: '~ If y!?S, describe under ~-~ Spr-CI.AI PROVIS!Of\JS helnw El. DISE!\SE P(!lICY L1',;I!T i :f, OTHER I I I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS COLOR42 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTlCE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OIlLlGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR CERTIFICATE HOLDER Colorado Water Conservation Board 1580 Loqan Street suite 750 Denver CO 80203 @ACORD CORPORATION 1988 ACORD 25 (2001/08)