HomeMy WebLinkAboutFIRSTONSITE USA HOLDINGS, INC - INSURANCE CERTIFICATEr� ALLIEO
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AL.LtED WORLD ASSURANCE COMPANY (U.S.) INC.
199 Water Street, 24'h Floor, New York, NY 10038 • Tel. {646} 794-050d • Fax (648) 794-Ofi11
fTEM 1.
(TEM 2.
ENVIRQNMENTAL EXCESS LIABILITY POLICY
DECLARATIONS
Palicy No: 0312-4766 New/Renewal of: 0312-4766
fVAMED INSURED: First4nSite USA Holdings, InC
fi200 S Syracuse Way, Suite 230
ADDRESS: Greenwood Viflage, CO 80111
POLICY PERIOD: From: December 37, 2023 Ta: December 3f, 2024
[12:01 A.M. standard time at the address stated in Item 1 abovej
REM 3. L1MI7S OF THIS INSURANCE:
US$10,000,000
US$10,Q00,000
Per Incident Limit
Policy Aggregate Limit (as defined in the First Underfying
Ir�surance Policy)
ITEM 4. SCHEDULE OF UNDERLYING INSURANCE:
$1,000,000
$2,000,000
$2,00a,000
$1,000,000
$1,000,000
$1,000,000
$1,000,000
$�,00a,000
Prlmary
Westchester Specialty Insurance Services, 1nc.
Policy Number: G24086446 015
Each Occurrence
General Aggregate
Products Gompleted Operations Aggregate
Personal and Advertising Injury
Contractor's Pollution Liability — Each Pollution Condition
Professional Liability - Each Claim
Onsite Cleanup — Each Pollution Condition
Third Party Prernises Poliution — Each Pollution Condition
Employer Liability
Arch Insurance Group
Policy Numbers:
31 W C 18988fi01
34W C 4 8988701
$1,000,0�0 Each Accident (BI by accident}
$1,000,000 Policy Limit (BI by disease)
$1,000,000 �ach Employee (BI by disease)
Auto
Arch Insurance Group
Policy Number: 31 CAB898861
SURPLUS LINES LICENSEE: CRC Corporate License 183767
$2,000,000 Combined Single Limit This contract is deiivered as a surplus line coverage under the
'Nonadmitted Insurance AcY. The insurer issuing this contr�ct i;
not licensed in Colorado but is an ELIGIBLE nonadmitted
insurer. There is na protection under the provisians oi the
'Colorado Insurance Guaranty Association Act'.
ENV-X5 OOQQ1 00 (06/12j Page 1 of 3
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