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c~corcJ~ • <br />ISSUE DATE (MM/DDM') <br />II o~ on <br />PRODUCER THIS CERTIFlCATE IS 55UED AS A MATTER OF INFORMATION ONLY AND CONFERS <br /> NO RIGHTS UPON 7NE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, <br /> EIITEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Curtis Rahm 39-070 COMPANIES AFFORDING COVERAGE <br /> COMPANY A <br /> LETTER Colorado Farm Bureau Mutual Insurance Co. <br /> COMPANY <br /> s <br />LETTER <br />INSURED <br /> <br />Jack Perrin COMPANY <br />LETTEq C. <br /> <br />Perrin Construction <br />131 Carllt05 COMPANY D <br />LETTER <br /> <br />Grand Jct., CO SISO1 ~ <br /> COMPANY <br />E RECLAA4ATIOFI OIV1510 <br /> LETTER <br />~ '. <br /> <br />THIS IS TO CERTIFY THAT POLICES OFINSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDfTION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY <br />BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDI- <br />TIONS OF SUCH POLICIES. <br />"O <br />PE <br />F <br />S <br />F <br />CE PoLIGY EFFECTNE PoUCV E%PIflATIDN LIABILITY LIMITS IN THOUSANDS <br />.TR IN <br />U\N <br />TY <br />O <br />U POLICY NUMBER DATE (MMDWYIT DATE (MWOWVIT En N <br />OCCURRENCE <br />AGGREGATE <br /> GE NERAL LIABILITY BODILY <br /> X COMPREHENSIVE FORM INJURY C <br />,P $ <br /> X PREMISES/OPERATIONS pROPERrY <br />4 X UNDERGROUND DAMAGE $ $ <br /> BfPE85IBN-6 COLLAPSE HAZARD <br /> <br /> }~ PROOUCTSlCOMPLETEO OPERPTIONS GL-30522 1 5- 15-89 5- 15-90 <br /> CONTRACTUAL ela PD <br />COMBINED C¢. <br />~P SOO C <br />$ SOO <br /> X INDEPENDENT CONTRACTORS <br /> BROAD FORM PROPERTY DAMAGE <br /> X PERSONAL INJUflV PERSONAL IWURV $ 50D <br /> A UTOMOBILE LIABILITY BOplr . S-R;~, <br />""~ <br /> <br />ANY AUTO Y1DRY <br />AER RRSP`A <br />$ :iy¢ <br />~ : S*~t"-", <br /> ALL OWNED AUTOS (PRN. PA55.) gpD~r -.„:x'.~~'^~~ <br />e <br /> ALL OWNED AUTOS OTHER THAN ~ ~RR~rmoFNq $ _ <br />~,'' ~ <br />~ <br /> HIRED AUTOS PROPERTY ~ ~'~~`' ~~~r .. <br />~ <br />' <br /> NON-0WNEO AUTOS DAMAGE $ r° <br />ilyq <br />:'w <br /> u' <br />R <br /> <br />GARAGE LIABILITY .j..y <br />~'~~ <br />~,; `.y r•3;. <br /> BI 6 PD <br />COMBINED <br />$ <br />``.Th . <br /> EXCESS LIABILfTY <br /> UMBRELLA FORM BI a PD <br />COMBINED Ca~ <br />~P c <br />$ <br /> OTHER THAN UMBRELLA FORM <br /> <br />' STATUTORY I'^r°°.~'.'^r+e{. <, <br />' <br /> WORKERS <br />COMPENSATION $ (EACH ACCIDENT) <br /> ~ ~ _ <br />;: <br />_ <br /> AND <br />' „ ,~ <br />.. <br />°ti`~iy, <br />$ (DISEASE~POLICY LIMIT) <br /> EMPLOYERS <br />LIABILITY "- $ (DISEASE~EACH EMPLOYEE) <br /> OTHER <br />DESCRIPTION OF OPEFNTIONS/LOCATIONSNEHICLES/SPECIAL ITEMS <br />Excavation and Construction <br />Department of Natural Resources <br />1313 Sherman St., Room 215 <br />Denver, CO 80203 <br />Attn: Mr. Tom Gillis <br />SHOULD ANY OF THE ABOVE DESCR <br />PIRATION DATE TN OF, THE <br />MAIL I S DAYS EN NO <br />LEFT, BUT FAd SUCH <br />OF ANY KRiD HE COMPAI/Y <br />BE CANCELLED BEFORE THE EX• <br />M WILL ENDEAVOR TO <br />DER NAMED TO 7NE <br />NO TKJN OR LNBILffY <br /> <br />