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<br />ACORD~ <br /> <br />CERTIFICATE OF LIABILITY INSURANCE <br /> <br /> <br />DATE (MMJOO/YYY <br />CONSO-4 02 :l. 3 0' <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMA' <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BEL <br /> <br />INSURER A: <br />INSURER B: <br />INSURER C: <br />INSURER D: <br />.INSURER E: <br /> <br />CANCELLATION <br /> <br /> <br />INSURERS AFFORDING COVERAGE <br /> <br />NAIC# <br /> <br />American ~ternative Insurance <br /> <br />Pinnacol Assurance <br /> <br />411.90 <br /> <br />PRODUCER <br /> <br />Hix Insurance Associates, Inc. <br />4440 Arapahoe Ave., Ste 100 <br />"1lder CO 80303 <br />hne:303-444-4666 Fax:303-444-8481 <br /> <br />,,,,;sURED <br /> <br />The Consolidated Home Supply <br />Ditch and Reservoir Company <br />1650 West 8th st. <br />Loveland CO 80537 <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELPW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHST AN DING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> TYPE OF INSURANCE POLICY NUMBER PO~% EFFECTI~E P8k~~Y{~lf,b~1~~~N LIMITS <br />LTR NSR DATE MM/DD/YY <br /> GENERAL LIABILITY EACH OCCURRENCE $1,000,000 <br /> I-- r-UAMI\(j~ <br />A X COMMERCIAL GENERAL LIABILITY SDISSK91024372 03/01/07 03/01/08 PREMISES (Ea occurence) $1,000,000 <br /> I CLAIMS MADE [KJ OCCUR MED EXP (Anyone person) $ 10,000 <br /> PERSONAL & ADV INJURY $ 1,000 LQ.DO <br /> I-- -" <br /> X D&O/EPLI/EBL GENERAL AGGREGATE $ 3,000,000 <br /> I--- <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COM~OPAGG $3,000,000 <br /> ~ .nPRO- n <br /> POLICY JECT LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGtE LIMIT <br /> - $ <br /> ANY AUTO (Ea accident) <br /> - <br /> ALL OWNED AUTOS BODILY INJURY <br /> I-- $ <br /> SCHEDULED AUTOS (Per person) <br /> I-- <br /> HIRED AUTOS BODILY INJURY <br /> I-- $ <br /> NON-OWNED AUTOS (Per accident) <br /> - <br /> - PROPERTY DAMAGE $ <br /> (Per accident) <br /> GARAGE LIABILITY I AUTO ONLY - EA ACCIDENT <br />'0. $ <br /> ===1 ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ <br /> ~ OCCUR o CLAIMS MAOE AGGREGATE $ <br /> $ <br /> ~ DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND X I TORY LIMITS I IU~~- <br />B EMPLOYERS' LIABILITY 71362 12/01/06 12/01/07 <br />ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $ 500000 <br /> OFFICER/MEMBER EXCLUDED? E.L DISEASE - EA EMPLOYEE $ 500000 <br /> ~~E~,itS~~~v~~~~~s below Et. DISEASE - POLICY LIMIT $ 500000 <br /> OTHER <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />Irrigation Works Operati?ns 48 Miles of Ditch <br /> <br />CERTIFICATE HOLDER <br /> <br />COLOR2 0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATI <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />REPRESENTATIVES. <br />AUTH I REPRES <br /> <br />Colorado Water <br />Conservation Board <br />1580 Logan St., Suite 750 <br />Denver CO 80203 <br /> <br />ACORD 25 (2001108) <br /> <br />~.- <br /> <br />@ ACORD CORPORATlm <br />