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<br /> :C. !i:Sv ti\:•: L4 .i:Fi} �vti'v v:4:: •1:44?.Svnv.:•:h}: -i'PRooucER
<br /> 6/23/1993
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
<br /> CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
<br /> Neil-Garinq Agency, Inc. DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
<br /> P.O. Box 1576 POLICIES BELOW.
<br /> }.............................................................................................................................................. ....... .... .
<br /> Glenwood Springs, CO 81602-157 COMPANIES AFFORDING COVERAGE
<br /> (303) 945-9111
<br /> ...... ............................................ .. .... ... ... .......I..................... . ... ....... ...
<br /> my
<br /> cow
<br /> LETTER
<br /> A Hawkeye-Security Insurance Co.
<br /> ............ .. ....................................... .. .......... ............................ .. '
<br /> LETERNY
<br /> B
<br /> INSURED
<br /> ........................... ................................ .......... ..... ............. ... ...................................
<br /> Dirt N Iron, Michael Frisk dba � C
<br /> & Jerry's Excavating ................................................................................................... .................................................
<br /> 1417 326 Road COMPANY D
<br /> Silt CO 81652 LETrETa
<br /> ........................................................................................................................................ ... ........ .
<br /> CaMPANv E
<br /> LETTER
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<br /> :.... �tl.•4.i7..f.. ..;.•,.............:...t.......,r.................................. . .:..::.�;{{.........,,fa: ...c........ .tv........ , .h,.:••:,,:,•::._:::::,.
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<br /> n.v,.:•At}Y.hVi:Vdvv�,4}T•.:�:'::,4..�}d'O:•-}:v N'+v>(w?4{.?W::h...1'..h:\\:::�-?Y:S::X--::-::LG}Sifvxfiht+' ..........
<br /> x„+v.\,•. ..... .n'?:.v:4?U•'+Wi36:{4'._:::4v:::_i hi i}::�::.i
<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 /> IND!CATED, NOTWITHSTANDING ANY REOUIREMENT, TERM.. OR CONDr ION OF ANY CONTRACT OR OTHER DOCUMU!T W!TH RECPECT 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 /> .........................................................................•--•-•--------................................................................................................................................................................................. .
<br /> CO: TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTNE POLICY 03 RAIM
<br /> LTR i Lam
<br /> DATE (MMfDD" DATE(MM�DDtM
<br /> ............................................................................................. ........................................................................i........................
<br /> A GENERAL LIABILITY
<br /> GENERAL AGGREGATE s 1 0 0 0{0 C
<br /> ...... .....r
<br /> } % I COMMERCIAL GENERAL L.IABL.ITY PP 064357 ATP AGG. s 1,000,0 C
<br /> CLAIMS MADE % .00CUR
<br /> ............................................
<br /> �sauL a env.wuar........=....1....0.0.0....O.0
<br /> ......... :05/15/93 ; OS/ 15/94 . -. ,-
<br /> OWNERIS a CONTRACTORS PROT. EACH OCCURRENCE s 1 0 0 0 O C
<br /> :...........!......................
<br /> FIRE DAMAGE(Any one fire) :i so,0 C
<br /> .. ................. .. ....... ... . ----
<br /> MED.El0 ENSE(Mr«re Penn^): .5,0 C
<br /> :..................................................................,........... ......... ..................................................... ........... -.................................. ...............----...... .. ...................
<br /> iALRDYOBILE LLABtJTY COMBWED SINGLE
<br /> ANY AUTO L.MIT if
<br /> :................................................;.....................-............
<br /> ALL OWNED AUTOS
<br /> i SC7•aXXED AUTOS GODLY N. :(per person)
<br /> �S
<br /> ......... ........................... .
<br /> HIRED AUTOS BODILY 141M
<br /> NON-OWNED AUTOS (Per accident) _
<br /> iGARAGE LIABLRY ......................•-•--•-----............----s-----------....................-
<br /> ` PROPERTY DAMAGE ;t
<br /> E7(CESS tJABii lir........................................................ {....................................
<br /> ..............................................
<br /> :..............................
<br /> EACH OCCURRENCE iS
<br /> {
<br /> LAMNELA FORM :AGGREGATE
<br /> OTHER THAN UM9IIBIA FORM
<br /> ............. .... ....... . . ....... .
<br /> w�.$COMPENSATION STATUTORY Lr)ITS
<br /> : ................................................................ ...... ...
<br /> AND EACH ACCI"T
<br /> ........... .... - ..
<br /> : DRSFASE.-.POLICY LMR i
<br /> EMPLOYERS LULBLITY :....... ...............................DISEASE-EACH EMPLOYEE S
<br /> > --- ... .. ... . ...... .. . -
<br /> OTHER
<br /> RECEIVED
<br /> ....................................... - .....: .-- -
<br /> DE9CRIPWN OF OPERATIONSAACATION&VEHICLMSPMAL ITUO
<br /> Certificate Holder is Additional Insured. Juu25
<br /> DIV!S1 0F
<br /> c EATi MCA <:_<:>>
<br /> :.. .. .. . . ........ .........::::................::.:-......................:.......::C7�i+iCE1:E�3lOJt�::;::::<:>::;::»:.}::>:::<:>::>::;»:.»»:.}--;:;.}::}}:>.s:::;r.}::;::-.;;:.i..,.;;:..:.:;. ":> <'.;=
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
<br /> EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
<br /> MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
<br /> State of Colorado Dept. of Nat Res LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
<br /> Maggie Van Clief :>:: LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
<br /> 1313 Sherman Room 215 >A REPRESENTATIVE
<br /> Denver CO 80203
<br /> _ IJ
<br /> -
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