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LPPD000481
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Last modified
11/19/2009 11:01:24 AM
Creation date
4/3/2007 8:26:07 PM
Metadata
Fields
Template:
Loan Projects
Contract/PO #
C150177
Contractor Name
Smart Brothers, Inc.
Contract Type
Loan
Water District
64
County
Logan
Loan Projects - Doc Type
Project Completion Letter
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<br />Carruthers State Farm Ins 970 522 6664 <br />Apr-25-06 lO:16A <br /> <br />P.03 <br /> <br />CERTIFICATE OF INSURANCE <br /> <br />This certifies that <br /> <br />t81 STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois <br />o STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois <br />o STATE FARM FIRE AND CASUALTY COMPANY, Scarborough, Ontario <br />o STATE FARM FLORIDA INSURANCE COMPANY, Winter Haven, Florida <br />INSURANC. 0 STATE FARM LLOYDS, Dallas, Texas <br />, ".. 'ng policyholder for the coverages indicated below: <br />Name of policyholder SMART BROTHERS INC <br /> <br />ST"TI '''AM <br /> <br />A <br /> <br />in <br /> <br />Address of policyholder 15008 COUNTY ROAD 310 ATWOOD, CO 80722 <br /> <br />Location of operations MULTIPLE <br />Description of operations FARM/RANCH <br /> <br />The policies listed below have been issued to the policyholder for the policy periOdS shown. The insurance described in these policies is <br />subject to all the terms exclusions, and conditions of those policies. The limits of liability shown may have been reduced by any paid claims. <br /> <br />POLICY NUMBER <br /> <br />POLICY PERIOD <br />TYPE OF INSURANCE Effective Date: Expiration Date <br /> <br />LIMITS OF LIABILITY <br />(at beginning of policy period) <br />BODilY INJURY AND <br />PROPERTY DAMAGE <br /> <br />Comprehensive : <br />96-BM-9106-4 Business liability 08/29/05 : 08/29/06 <br />. -This"insurance -includes: - - - ti -Products--- CompJete<.-Operatlons - -- - - - - - - -" -- - u_ - - - - - -- --- <br />o Contractual liability <br />o Underground Hazard Coverage <br />o Personal Injury <br />o Advertising Injury <br />o Explosion Hazard Coverage <br />o Collapse Hazard Coverage <br />IZI FARM LIABILITY <br />o <br /> <br />Each Occurrence $ 100,000 <br /> <br />General Aggregate $ 200, 000 <br /> <br />Products - Completed $ 200, 000 <br />Operations Aggregate <br /> <br />86-48-6478-9 <br /> <br />EXCESS LIABILITY <br />181 Umbrella <br />o Other <br /> <br />POLICY PERIOD <br />Effective Date : Expiration Date <br />01/01/06 : 01/01/07 <br />, <br />, <br /> <br />BODilY INJURY AND PROPERTY DAMAGE <br />(Combined Single limit) <br />Each Occurrence $ 1, 000, 000 <br />Aggregate $ .-'-. <br />Part 1 STATUTORY <br />Part 2 BODilY INJURY <br /> <br />Workers' Compensation <br />and Employers liability <br /> <br />Each Accident $ <br />Disease Each Employee $ <br />Disease - Policy limit $ <br /> <br />POLICY NUMBER <br /> <br />POLICY PERIOD <br />TYPE OF INSURANCE Effective Date : Expiration Date <br /> <br />LIMITS OF LIABILITY <br />(at beginning of policy period) <br /> <br />THE CERTIFICATE OF INSURANCE IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIRMATIVELY NOR NEGATIVELY <br />AMENDS, EXTENDS OR ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN. <br />If any of the described policies are canceled before <br />its expiration date, State Fann will try to mail a written <br />notice to the certificate holder 30 days before <br />cancellation. If however, we fail to mail such notice, <br />no obligation or liability will be imposed on State <br />Fa or its agents or representative. <br /> <br />Name and Address of Certificate Holder <br /> <br />ATT: STEVE BIONDO <br />COLORADO WATER CONSERVATIONS BOARD <br />DEPARTMENT OF NATURAL RESOURCES <br />1580 LOGAN STREET SUITE 750 <br />DENVER, CO 80203 <br /> <br /> <br />.J..J..' <br /> <br />...... <br />: <br />I <br />1828 <br />F625 <br /> <br />AF( <br /> <br />LeRion of Honor <br />J..'ode F625. . <br />R.CARRUTHERS <br />NORTHER~_COLORADO <br /> <br />55B-994 a.3 04-1999 Printed in U.S.A. <br /> <br />~ <br />
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