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A ° DATE(MMlDDlYYYY) <br /> ® CERTIFICATE OF LIABILITY INSURANCE 1/19/2012 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pollcy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to <br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder In lieu of such endorsement(s). <br /> PRODUCER NAME: Account Manager -_ <br /> Van Gilder Insurance Corp. <br /> 1515 Wynkoop Street "MAIL.E,q:(303)837-8500 INC.Not:(303)831-5295 <br /> Suite 200 .AoDRE3s:certifjcate@vgic.com <br /> Denver CO 80202 INSURER(S)AFFORDING COVERAGE NAIC# <br /> _-INSURER A:�,-St. Paul Fire&Marine Insu — <br /> INSURED <br /> INSURER B:elM8C01 Assurance <br /> The Consolidated Mutual Water Company INSURER c:Hanover Insurance _ <br /> P.O. Box 150068 INSURER D: <br /> 12700 West 27th Avenue INSURER E <br /> Lakewood CO 80215 --- <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:174403328 REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> INSR WVD POLICY NUMBER (MM/DD/YYYY) (M IYYY) <br /> M/DDY _ <br /> C GENERAL LIABILITY Y Y ZDF892755500 2/1/2011 2/1/2012 EACH OCCURRENCE $1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY DAMAGE SES S(RENTED <br /> (Ea occurrence] $500,000 <br /> CLAIMS-MADE X OCCUR MED EXP(Any one person) $5,000 <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GENERAL AGGREGATE $2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 <br /> —1 POLICY PRO TC1 LOC $ <br /> C AUTOMOBILE LIABILITY Y , AWF898563300 12/1/2011 2/1/2012 COMBINED SINGLE LIMIT <br /> (Ea accident) $1,000,000 <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS _ AUTOS <br /> X X NON-OWNED PROPERTY DAMAGE $ <br /> HIRED AUTOS _ AUTOS (Per accident) <br /> A X UMBRELLA LIAB OCCUR QK300841 2/1/2011 2/1/2012 EACH OCCURRENCE $20,000,000 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $20,000,000 ^~ <br /> DED l X RETENTION$10,000 $ <br /> B WORKERS COMPENSATION 114652 2/1/2011 711/2012 • X I Wtr STATU- !Om <br /> YIN EMPLOYERS'LIABILITY <br /> Y/N —-T.QRY LIMITS I ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $1,000,000 <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) <br /> The Colorado Water Conservation Board is included as Additional Insured. <br /> CERTIFICATE HOLDER CANCELLATION <br /> . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Colorado Water Conservation Board ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 1313 Sherman St., Room 721 <br /> Attn: Ryan Edwards AUTHORIZED REPRESENTATIVE <br /> Denver CO 80203 � ��� _r, <br /> 1 �% <br /> ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD <br />