HomeMy WebLinkAboutIxom Watercare Inc. - Insurance Certificate 2025---A<:ORD"txoMWAT.0.t
CERTIFICATE OF LIABIL]TY INSURANCE 3t't7t2025
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: It the certificate holder is an ADDITIONAL INSU RED, the policy(ies) m ust have ADDITIONAL INSURED provisions or b€ endorsed
, subject to the lerms and conditions of the policy, certain policies may require an endorsemenl. A statement on
rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVEO
this certificate does not confer
fi?ill cr Phoebe Kuntz
fI3)ri., e,q, (701) 22a-70a3 [#, r.r,(701 ) 483-1234
!ffi1.5" p.kunE@insurewithchoice.com
INSURED
Nsunen o , Continental Casualty Company
Choice lnsurance
323't8th St W
Dickinson, ND 5860'l
41297
35289
15s80
20443
rNsuRER B , The Continental lnsurance Company
rNsURER c :Scottsdale lndemnity Company
'xom
Watercare lnc.
3225 Highway 22 N
Dickinson, ND 58601
INSURER E
lllsluSqltsl aEFoRDrNq cqvERAGEssoigdc!e!!!!Er!e! []r
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED NOTWTHSTANDING ANY REQUIREI\,,IENT, TERM OR CONDIIION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT-TO W]ICH THIS
CERTIFICATE MAY BE ISSUED OR I\,,IAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SU EJECT TO ALL THE TERMS
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHO!\N MAY HAVE BEEN REDUCED BY PAID CLAIMS
TYPE OF TNSURANCEINSR
LTR
AODL SUAR POLICY EFF POLICY EXP
IMM/OD/YYYYI IMM/ODTYYYY]
: EACH OCCURBEIIqE
3/222026 BAS0EEE{?E:ES5B"-)
MED EXP (Anv one person)
PERSONAL & AOV INJURY
't,000,000
100,000
10,000
l,OOO,OOO
2,000,000
2,000,000
1,000,000
s
5
5
s
$
x vRS0008047
GENERAL AGGREGAIE
312212025
X . coMMERclaL GENERAL LtaBlLtry
cLArMs r,rADE X occuR
X Employer's Liability
GEN'L AGGREGATE LIMITAPPTIES PER["o,,""fffi [l,oc
OTHER ND OH WA WY PUE $
O\AAED
AUTOS ONLY
H RED
AUTOS ONLY
1,000,000
8UA7014690902XX
COMB NED S NGIE I i/lIT
SCHEDULED
AUTOS
NON OV\NED
AI]TOS ONLY
B eutouogtLe LngtLttv
5,000,000
s,000,000vES0004954$
$
x 5
X
0
3t2212025 312212026 o""*."o_.
OCCUR
CLA]MS.I\IAOE
oEo X RETENTIoN $
EXCESS LIAA
D woRKERs coMPENsanoN
AND EMPLOYERS' LlABIUTY
ANY PROPR ETOR/PARTNER/EXECUT VE
OFFICER/MEMBER EXCLUDED?(Mandalory in NH)
yes descrrb€ under
DFSCRIPTION OF OPFRATIONS t r.*
w PFF
^ srarLrrF
3t2212025 3t22t2026 .. .o.ro.. o.*,1,000,000
1,000,000
1,000,000
5
OTH
ER
EL OISEASE EA EMPLOYEE $
E L DISEASE, POLICY LIMIT $
DESCRIPTION OF OPERATIONS / LOCATIONS / VEH,CLES {ACOR D 101 , Addirional Remarts S.h€dule, may be a(..hed it more space is rcquired)
Certificate holder is included as additional ins!red with respects to General Liability and Automobile Liability iI required by written contract per form #'s
cG2010(04-13) & CNA71527XX(10-121.
E TIFI MBER:REVISION NUMBER
312212025 312212026 Pollution Occurrence
312212025 312212026 Pollution Aggregate
A Contractors
A Contractors
vRS0008047
vRS0008047
1,000,000
2,000,000
CERTIFICATE HOLOER
O 1988-2015 ACORD CORPORATION. All rights reserved
The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVEREO IN
ACCORDANCE WITH THE POLICY PROVISIONS,
Q---l)' r" z
AUTI]OR ZED REPRESENTAT VE
City of Fort Collins
Purchasing Divison
PO Box 580
Fort Collins, CO 80522
ACORD 25 (2016/03)
I
312212025 312212026 [-eqo rv ruunv leer personl s
BOD tw t\JUcY ec. r ,,o.nr.. g
PPOPFON DAMAGFtP..d(, de-, . $
.$
wc714690S16