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Home My WebLink AboutAcord-6/14/2010A'co►a cr CERTIFICATE OF LIABILITY INSURANCE `,r.�.--" DATE(MM/DD/YYYY) 06/11/2010 PRODUCER LSB Financial 219 Main Street Cedar Falls, IA 50613 Ph: 319-268-4242 Fax: 319-268-4211 THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Peterson Contractors, Inc. Reinbeck Motors, Inc. PO Box A 104 Blackhawk Street Reinbeck, IA 50669 INSURER A: The Travelers Indemnity Company 25658 INSURER B: Travelers Property Casualty Company 25674 INSURER C: The Travelers Indemnity Company of CT 25682 INSURER 0: The Travelers Indemnity Company 25658 INSURER E: $ 1,000,000 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADD'L INSRD TYPE OF INSURANCE POLICY NUMBER POUCY EFFECTIVE DATE (MM/DDIYY) POLICY EXPIRATION DATE (MMIDDIYY) OMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY VTNC07880B883PHX09 07/01/2009 07/01/2010 EACH OCCURRENCE $ 1,000,000 X ED PREMISES TOocceurence) $ 300,000 CLAIMS MADE X OCCUR MED EXP (Any one person) $ 10,000 X Blanket Contractual PERSONAL & ADV INJURY $ 1,000,000 X XCU Coverage Included GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 7 POLICY X 1138-i, — LOC $ B AUTOMOBILE LIABIUTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS VTJCAP3510A26ATIL09 07/01/2009 07/01/2010 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABIUTY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ A EXCESS/UMBRELLA LIABILITY VTSMKCUP3510A271INDO9 07/01/2009 07/01/2010 EACH OCCURRENCE $ 1,000,000 X OCCUR CLAIMS MADE AGGREGATE $ 1,000,000 DEDUCTIBLE RETENTION $ 10,000 $ $ X $ C' WORKERS COMPENSATION AND EMPLOYERS' UABIUTY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below VTC2EUB9123B85509 07/01/2009 07/01/2010 X TORY LAMITS T-41- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 D OTHER Cargo Rent / Lease Equipment QT660140D7836TIA09 07/01/2009 07/01/2010 $ 800,000 $ 750,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS FOR THE PROJECT DESCRIBED AS FY 2010 RIVERVIEW RECREATION AREA (OHV), WATERLOO, IA, CONTRACT ID # 789, THE CITY OF WATERLOO IOWA IS NAMED AS AN ADDITIONAL INSURED PER WRITTEN CONTRACT REQUIREMENTS. PCI # J3157 FICATE HOLDER CITY OF WATERLOO DEPARTMENT OF ENGINEERING 715 MULBERY STREET WATERLOO, IA 50703 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE��/�� 4%.�M�� - —•--.. ___ ACORD 25 (2001/08) IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statment on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute: a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08)