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<br />At~..ltlt.
<br />
<br />CERTiFic.e OF INSURANCE~--.
<br />
<br />PRODUCER
<br />
<br />Van Gi I.dE'\~ Insu\-anc:e C::orp
<br />700 Br'oadway, Su i tf,' WOO RECEIVED
<br />
<br />Denver, CO 80203
<br />
<br />DEe 2 4 1997
<br />
<br />",' DATE (MMlDDNY) J'
<br />1,2/11./97
<br />r------------- -. -- --.. ------~-------------- ---------------------~,~~-.--
<br />I THIS CERTIACATE IS ISSUED AS A MATTER OF INFORMATION ONLY I
<br />: AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS i
<br />, CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE
<br />i ,COVERAGE AFFORDED BY THE POLICIES BELOW. ~ i
<br />; ----- -- cOMPANiEs AFFORDING COVERAGE ------ ~ "', I
<br />I" cOMlANY --------------------------- - ---- ---- ----1
<br />I Hartford Fire Insurance Co i
<br />,
<br />iro_w I
<br />,B Hartford Casualty Ins Co I
<br />~- -~ --~-- ~--~----~-~- -- ~--I
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<br />COMPANY
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<br />~~():5-,83'7-8500
<br />INSU liOIoraoo "qaun
<br />RED Conservation Board
<br />Mcl.. <l ugh l i n W.:de,- Eng i neer' cd 98)
<br />2420 Alcott Street
<br />n"1nve,-. CO 80211
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<br />COMPANY
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<br />'-COVERAGES
<br />
<br />THIS 1$ TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED, N01WITHSTAND1NG 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, I
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />
<br />TYPE OF INSURANCE POLICY NUMBER ~~~-I~';~~E,~~UJPO, LICY EXPIRATIO, N I: -"-, LIMITS, ~'
<br />) DAT~ (MMlDDIYY) DATE (MMlDDIYY) _ _
<br />~~.._----- ~'-'- - ----- .
<br />GENERAL LIABILITY I : I ~~ENE_~_L_~~_?_~~~!~__l.!~~ t_~g~~_~~~
<br />A X roMMERCIALGENERAL LlAllILlTY i ;'54SF.<AG,J5838 1./01./98, 1/0l/99~PROD-"~~-coMP/OP~~GG~.-?OO~000;
<br />i CLAIMS MADE ~ OCCUR I : i_~~~~_ONA~~~~_~,~~_~_~~m_.J~_ ~__!_,??<?_!..~~Oi
<br />
<br />OWNER'S & CaNT PROT ! '!:~~D~:ci:~:~:~fi~~) --fP.-!~gg~-:-~~~
<br />---- I r-MEDE-XP (An-y-~-;;;;~~-~)----Ti--- - --lOt 0061
<br />---------------,~--------i-i----I
<br />1/0 l/98 i 1/01 /991 COMBINE~SI~GLE LlMrr J$],_~ ()~O, ()O()-1!
<br />, I
<br />i BODILY INJURY I $ " 'I
<br />(Per Person) _
<br />-----------1------- 1
<br />BODILY INJURY I $ ~
<br />(Per Accident) I ~
<br />,___H_ ___~__~_+-~ " _
<br />I ,
<br />PROPERTY DAMAGE i $ .
<br />+-------_~____~_l
<br />
<br />i~~~:~~:~~~~~~~~~=-=~~==-~
<br />f---- EACHAC~~EN~-!- -------------- ..----..--1
<br />-1- ! AGGREGATE I $ -I
<br />- ---- ! !EACH OCCURRENCE 1$ 1 ,000, 000 ~
<br />1/0l/98! 1/01 /99 r~GG~EG~~~-:-_=--':'~- r$1~OOO ,000
<br />1 I r;:eten't i on $ 10,000
<br />
<br />nT-1 /0 1 /~~-~-l-;O j~;;~~::~~:::; LIMITS ""'$__, J, 00 . 000 ~
<br />:~~~~SE - ~OLlC.:!'..,:!MIT _-----'-!.____~~.q.!..9()O ~
<br />lOlsEASE - EACH EMPLOYEE $ 100 t 000.tj
<br />----------,-------- ~ ~ I
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<br />ro
<br />LTR
<br />
<br />AUTOMOBILE LIABILITY
<br />A Xl ANY AlJTO
<br />ALL OWNED AUTOS
<br />
<br />34UENEZ21.1.2
<br />
<br />SCHEDULED AUTOS
<br />X HIRED AUTOS
<br />X NON-0WNED AUTOS
<br />
<br />I------ ---------
<br />
<br />GARAGE LIABILITY
<br />! ---j ANY AUTO
<br />!I
<br />f-- ~---------
<br />!
<br />
<br />e~ESS L1ABIL.lTY
<br />B i X UMBRELLA FORM
<br />~
<br />i OTHER THAN UMBRELLA FORM
<br />~ORKERS COMPENSATION AND
<br />A PLOV....' ",..,tRY U - ,3 41,JBr.<C6 :ro~'
<br />lliE PROPRIETOR! I X llNCl '
<br />PARTNERs/EXECUTIVE __n I
<br />OFFICERS ARE: EXCL i
<br />, THER I
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<br />~HXHlJEZj,368
<br />
<br />-.-----'-----!--..-..----
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<br />____.---L-
<br />
<br />DESCRIPTION OF OPERATlONSJLOCATlONSlVEHICLES/SPECIAL ITEMS
<br />
<br />ColoroC\do Wai'(?rO COns.ervaotion BO,;'H-d is listed as an AdditioTl.f-ll. Insured under
<br />G."m?l-<' l & All t omob i (e L. i ab i l i ty 0" l y, in ,,,.,spec ts to the i ,- wo,-o, pe,-f or"med by
<br />th~'! in~;ure~_._~_T~,~~~~~~__~nd al.l pr_~J_~c:t~ as p_~r'__~r'i~.!(.~_!~ ~.F?_~cifit'-J~...,?-__C?n_!.~_a__~_!+
<br />CERTIFICATE HOLDER CANCELLATION
<br />
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br />
<br />Co lor'ado Wah>>r
<br />Conservation Board
<br />Attn: Carolyn ~dams
<br />1313 Sherman Street Room 721
<br />'(Ienvm- t CO B0203
<br />iACORD 25-$, (:v93)
<br />
<br />EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
<br />30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
<br />BUT FAILURE TO M S CH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
<br />
<br />
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<br />MPANUS~::'~::l ~~~~-I
<br />
<br />@ACORD CORPORATION 1993.]
<br />
<br />OF ANY D U
<br />, AUTHORIZED REP
<br />
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