HomeMy WebLinkAboutABC CHAPTER MERIT SHOP AUI - INSURANCE CERTIFICATEV-
ACORD.
DATE MM DD YY
02/27/07
PRODUCER
On Risk Services, Inc. of New Mexico
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
6000 Uptown Blvd NE
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
Suite 400
CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
Albuquerque NM 87110 USA
COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
PHONE SOS 889-6700 FAX- SOS 884-7831
INSURED INSURER A: Midwest Employers Cas. Co.
ABC NM Chapter Merit Shop -WC Group INSURER B:
AUI Inc.
P.O. BOX 9825 INSURER C.
Albuquerque NM 87119-9825 USA
INSURER D:
INSURER E:
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 POLICES 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
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVEPOLICY
DATE(MMIDDIYY)
EXPIRATION
DATE(MMIDDIYY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
FIRE DAMAGE(Any oim (ire)
COMMERCIAL GENERAL. LIABILITY
CLAIMS MADE ❑ OCCUR
MED EXP (Anyone Fetvn)
PERSONAL& ADV INJURY
GENERAL AGGREGATE
GEN'L AGGREGATE LIMIT APPLIES PER:
PRO-
POLICYEl JECT LOC
PRODUCTS - COMPIOP AGG
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
ANY AUTO
(Ea accident)
BODILY INJURY
ALL OWNED AUTOS
SCHEDULED AUTOS
( Per person)
BODILY INJURY
HIRED AUTOS
NON OWNED AUTOS
(Per accident)
PROPERTY DAMAGE
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
ANY AUTO
OTHERTHAN EA ACC
AUTO ONLY:
AGG
EXCESS LIABILITY
EACH OCCURRENCE
OCCUR ❑ CLAIMS MADE
AGGREGATE
DEDUCTIBLE
RETENTION
A
WORKERS COMPENSATION AND
EMPLOYERs'LIABILITY
EW0007548
SIR oeductible $400,000
03/01/07
03/01/08
X
WC STATU-
TORY LIMITS
I
OTH-
ER
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE -POLICY LIMIT
$1,000,000
E.L. DISEASE -EA EMPLOYEE
$1,000,000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESJEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: Pipe Bursting Project
City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
Purchasing Division DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
215 N. Mason Street 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Fort Collins CO 80522 USA BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES,
AUTHORIZED REPRESENTATIVE