Laserfiche WebLink
<br />NOV-05-04 FRI 09:00 AM Kellogg-E~ing-LeaviLL In <br /> <br />FAX NO, t <br /> <br />p, 03 <br /> <br />FARMERS ALLIANCE MUTUAL INS. CO. <br />1122 N. Main, McPherson, KS .7460-2848 <br />'~241-2200 <br /> <br />Earm'ers <br />~liance <br /> <br />_ n~..' ..._.rMIlI_ <br />POLICY NO. 01 05 AR 517527 <br />ACCOUNT NUMBER: 0186017 <br />, . <br />POLICY PERIOD: FROM 12-13-2004 <br /> <br />DECLARATION~, . 1028 <br />ATTACH ro POLICY'"( <br />This supersedes all previous delllaratlons <br />and states your current policy Coverage. <br />AGENT COPY <br />DIRECT BILL <br /> <br />FARMOWNERS <br />, RENEWAL <br />12-13-2004 <br />TO 12-13-2005 12:01 A.M. STANDARD TIME <br /> <br /> . ~9;t\~ :( <br />Ji~~~! GUENZIFARMSINCORPORATED 050151 (970)522-4840 FAX(970)522-7208 <br />,:el'I" 11079 COUNTY ROAD 250 ~Ij KELLOGG.EWING-LEAVITT AGCY, INC <br />(~.z . (' STERLING CO 80751-8329 PO BOX 1707 <br />':;~;;:::. STERLING CO 80751-1707 <br />j ;;~r~:~~j:' :~;.;.~,;f:Wi"i <br /> <br />Mamlld lmlurod; GUENZI FARMS INCORPORATED <br /> <br />Legal Entity: Other <br />Prlmar)' Risk Stllte: Colorado <br /> <br /> <br />Commorclal LiabIlity Coveralle <br />E~ch Occurrence Urnlt 1,000, QOi! <br /> <br />Coverage M Limit <br /> <br />5,000 <br />per per5ol1 <br /> <br />'General AGgregate Urnlt <br />(other than Products/Completed <br />Work) 2. ~OO. ODD <br />Products/Completed Work Ha2.lIrd <br />Aggregate L.lmlt 2, OOO~ 0011 <br /> <br />"Our" "limit" lor "property damag';" <br />covered undar Coverage 0 <br />/. 50,000 <br />This I'tIplaces the "limit" shown In <br />the polley. <br /> <br />Pereolllll LIability CQyerage <br />L Uabilily <br /> <br />each occurrence <br /> <br />M. Medical PaymootB 10 Othan <br />each perten <br />each accld",.~t <br /> <br />Products <br />Agllrellala Urnlt <br /> <br />1'1 <br /> <br />Deductlblus apply to All Collered Perils exc&pt where a separate Wind or Hall <br />deductible Is IndicBted. See Individual Items for applicable deductible. WH des- <br />illnllles Wind or Hail. <br /> <br />A. Residence <br />B. Related Private Structures <br />C. Penonal Property <br />D. Add/I Uving Cost and Fair Rental Value <br />E. Fann Barns, Buildings and Structures <br />F. Sch&duled farm Personal Property <br />G. Unacheduled Farm Personal Property <br />Premium Endorsements <br />Premium A.djustments <br /> <br />Personal Liability <br />Commercial Liability <br /> <br />Premllllll <br />3,546 <br />o <br />97 <br />o <br />2.701 <br />95 <br />2.181 <br />3.969 <br />64 <br /> <br />Insurance Score Discount <br /> <br />o <br />399 <br />1\12- <br /> <br />TOTAL PREMIUM FOR POLICY PERIOD <br /> <br />1Z.jS46 <br /> <br />THIS IS NOT A BILL. SEPARATE INVOICE TO FOLLOW, <br /> <br />PAVClR; GU,"NZI FARMS INCO)'{I.'ORATED <br />Preparlld By: Jani.ce EmerlQll <br /> <br />Form No. PO 44 0 01 SS <br /> <br />~5 <br />P"QIi' 1 Df 10 <br />