Laserfiche WebLink
<br />10-N1AY-200T 04:59PM FROh~Blanchard Insurance/HUB IntarnationalSW 9702458016 T-747 P.004/005 F-524 <br />ACORD„ CERTIIFICA-TE aF LIA,BIL~ITY INSURANCE 4PIp uw~tlMMrvwrrrTJ <br />s>;MCO-~ 05 to o~ <br />PRODUCER TH[S CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />FIQB Zaternational Southwest ONLY ANp CONFERS NO RIGHTS UPON 7HE CERTIFICATE <br />Blanchard Tmaurance Group HOLDER. THIS CERTIFICATE pOES NOT AMENp, EXTEND OR <br />P . O. Box 60130 ALTER THE COVERAGIH AFFORdED BY THE POLICIES SFLOW. <br />Grand Junction CO 81506 <br />Phoae:970-245-8011 FaLx:970-245-8016 INSURERS AFFORDING COVERAGE NAIC# <br />INSURED ~ INSURER A: F.IA ~O ez9 Mutual Casualt C <br />INSURER e: <br />$EM COarbYYliCtiDA CO. ~INSURERC; <br />627 24 1 2 lid, T]Ylit I INSURER D: <br />Grand Jtlnctioa CO 81505 -' <br />INSURER E: __ <br />COVERAGES <br />THE POLICIES OF INSURANCE U6TED DELOW NAVR PEBrI Is5UEp TO THE INSURED NAMED APOVE FOR THE POLICY PERIOD INCICATkp. NOTWIT}{sTANDING <br />TERM OR CONprnON OF ANY CONTRACT OR OTHER DOCUMENT V+RH RESPECT To WHICH YHIfi CERTIFICATE MAYBE IssuED OR <br />ANY REOUIREMENr <br />, <br />MAY PERTAIN, THC INSURANCE AFFORDED BY THE pOUCIGS pESCR)BEp HGREIN IS SUBJECT TO ALL THE TERMS, RrccLUBIONS ANp CONDITIONS OF 5uCH <br />POLICIEfi. aGGREGATE LIMITS sHOWN MAY HAVE BEEµ REDUCED aY PAID CLAIMS, <br />IlTR NSR TYPE OF INSURANCE PowcY NUMBER - ~DOATE MMroorrv DA M PP UMITs <br /> GENERAL LIABILITY EACH OCCURRENCE b 1, 000 000 <br />A X COMMERCiALGl=NFRALLIASILITY 9X90868 05/20/07 0510/OB PREMISES Eao~mlrencel 5100,000 <br /> CLAIMS MADE ~ OCCUR MED EXP fAnY opa person) b S , O0 0 <br /> PE/t90NALBApVIN~URy S 1 t)00 000 <br /> GENERAL AGGREGATE S Z OOO OOO <br /> GEN'L AGGREOAYfi LIMIT APALIliB PWi: PRODUCTS - CoMPlOP AGG b 2 OOO D D D <br /> POLICY j~~ LOC <br /> <br /> AUT OMOBILE LIABILITY COMBINEOfiINGLELItaIT b ~ r f)00 r ODD <br />A X ANY AUTO 9X90868 05/10/07 05/10/08 fEeeeeltlenu <br /> <br /> AU. OWNER AUT'O5 ppp1LY INJURY b <br /> 6CHEDUL6p Autos fPor person) <br /> <br /> X HIRED AUTOS BODILYIN,iURY ~ b <br /> X NON-OWNED AUTO& (Per aoGtlonU <br /> <br /> PROPERTY DAMAGE y <br /> fPer ~eel4enq <br /> OARAGE LIABILITY AUTO ONLY • EA ACCIDENT b <br /> ANYAUTa oTHERTHAN pAACC b - - <br /> AUTOONLY: AGG $ <br /> E%CES&UMRRELLALIABILITY GACFIOCCURRENCE $ <br /> OCCUR ~ CLAIMS MApE AGGREGATE 9: <br /> -_ b <br /> DEDUCTIBLE b <br /> RETENTION b ... 3 <br /> WORKERS COMPENSATION ANO ER• <br />TORY LReIT6 <br /> EMPLAYERS~ LIABILITY ,~, <br />E.L EACH ACCIDENT b <br /> ANY PROPRIETOR/PAA'rNERJEkECUTIVE <br />OFFtCERIMEMPF-R fxCLU0ED7 <br />E,L, pISEASE- EA EMPLOYEE <br />S <br /> It yyees, 4eB4'IbB under DISEASE • POLICY UMIY <br />E,L i <br /> SPGCIAL PROVISIONS eatow . <br />OTFIER <br />OESCRIP710N OF OPERATION& J LOCATIONS f VEHICLES 1 pfCLA1S10N9 AOOED eY ENDORSEMENT r SPECIAL PROVISIONS <br />RB: Biue Ribboa D~#,ne-'&'i1e DTo C-81-097. stage Of Colorado, Divieian Of <br />Dsinerala & Geology is iuc~.uded as an Additional znsuxed.*10 Daye rTOtice Due <br />to Non-Pa~rment Of Prel)aium. **Dr incur sul~staative changes or tai lure do <br />renew. <br />nw\,n~+~ wTn\1 <br />uCRlIr1UN+C ,'+ULYGI~ ~ - <br />6HOUL0 ANY OF THE AsDVE DESCR79ED POLlges 98 CANCELLED BEFORE THE EXPIRATION <br />0 0 0 0 0 0 0 <br />State OE Colorado DATE THEREOF, THEI6SUINGINSURERWILL6~r$MV-IL *3D DAYBWRITTEN <br />Division Of 'Minerals & Geology NOTICE TO THE CERTIFICATE HOLDER NAMED TO THELEPT,BUT Aw <br />3 Sharman Street Room Z15 <br />13 Mila ,eR11T/AFA4Y-v"•^`•^~+\+=w~+-~^"•~°pp~T'~ow• <br />fi <br />+ <br />~ <br />. <br />Denver CO 80203 + <br />Bg6116eR <br />I <br />N1f1 <br /> RGPREOd~MEBr ~ <br /> AUTHORIZED RRPRE3ENTATIVE - _ <br /> Vir ins Kornblut i -~/~ -~ ~~~ <br />•.,nr,n •T~nu sees <br /> <br /> <br />