HomeMy WebLinkAboutALLIED WASTE NORTH AMERICA - INSURANCE CERTIFICATE (2)ACORD. CERTIFICATE OF LIABILITY INSURANCE Page 1 of 3 12/04/2006
PRODUCER 877-945-7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Willis North America, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
26 Century Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P. O. Box 305191
Nashville, TN 372305191 INSURERS AFFORDING COVERAGE NAIC#
INSURED Allied Waste North America, Inc. INSURERA: American Home Assurance Company 19380-004
(Named Itd. Cont. Below) INSURERB: American Home Assurance Company 19390-005
18500 North Allied Way o� 1'
Phoenix, AZ 85054 INSURERC: Illinois National Ins. Co. 23817-002
INSURERD: National Union Fire Ins. Co. of Pittsburg 19445-001
INSURERE: Ins. Co. of the State of PA 1 19429-000
rV V IMMAlXC.I
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
D'
TYPE OFINSURANCE
POLICY NUMBER
POLICYEFFECTIVE
POLICY EXPIRATION
LIMBS
A
X
GENERAL LIABILITY
GL5835900
l/l/2007
l/l/2008
EACHOCCURRENCE
$ 2,500,000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE ®OCCUR
DAMAGETORENTED
PREMISES Ea oc urence
$ 100 000
MED EXP(Any one person)
$
PERSONAL& ADV INJURY
$ 2,500,000
GENERALAGGREGATE
$ 10,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY F PRO LOC
PRODUCTS-COMP/OP AGG
$ 51000,000
A
B
X
X
AUTOMOBILE
LIABILITY
ANVAUTO
CASS36660
CA5836661
l/1/2007
1/1/2007
1/1/2008
1/1/2008
COMBINED SINGLE LIMIT
(Ea accident)
$ S,OOOr OOO
X
BODILY INJURY
(Per person)
$
C
X
ALLOWNEDAUTOS
SCHEDULED AUTOS
CA5836662
1/l/2007
1/1/200$
BODILYINJURV
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTYDAMAGE
(Peramident)
$
GARAGE LIABILITY
AUTO ONLY -EA ACCIDENT
$
OTHERTHAN EA ACC
$
ANVAUTO
$
AUTO ONLY: AGG
D
X
EXCESSLIABILITY
X OCCUR CLAIMS MADE
BE4485809
1/1/2007
1/1/2008
EACHOCCURRENCE
$ 5,000,000
AGGREGATE
$ S 00O OOO
DEDUCTIBLE
$
RETENTION $
A
WORKERS
EMPLOYERS'LIABILITY PENSATION AND
WC2920646
1/1/2007
1/1/2008
TH-
X WByLIM_ITITIJ- OFEL
E.L. EACH ACCIDENT
$ 11000,000
A
L,
A
E
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED?
It yes, describe under
SPECIAL PROVISIONS below
OTHER
WC2920647
WC2920648
WC2920649
WC2920630
1/1/2007
1/1/2007
1 1 2007
1 1 2007
1/l/2008
1/1/2008
1 1 2008
1 1 2008
E.L. DISEASE -EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT $ 1,000,000
E
A
Workers Compensation
WC2920651
WC2920652
l/l/2007
l/l/2007
l/l/2008
l/l/2008
$1,000,000 Each Accident
$1,000,000 Disease Policy Limit
1 000 000 Limit Each Emrolovee
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Named Insured Includes BFI Northern Colorado
City of Fort Collins
P O Box 580
Fort Collins, CO 80522
D 25 (2001/08) CO
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 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
:1821828 Tpl:571017 Ceb4!8195420
ACORD CORPORATION 19RA
WI11IS
CERTIFICATE OF LIABILITY INSURANCE page 2 of 3
DATE
12/04/2006
PRODUCER
877-945-7378
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Willis North America, Inc.
26 Century Blvd.
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P. O. Box 305191
Nashville, IN 372305191
INSURERS AFFORDING COVERAGE
NAIC#
INSURED
Allied Waste North America, Inc.
INSURERA: American Home Assurance Company
19380-004
(Named Insd. Cont. Below)
18500 North Allied Way
INSURERB: American Rome Assurance Company
19360-005
INSURERC: Illinois National Ins. Co.
23817-002
Phoenix, AZ 85054
INSURERO: National Union Fire Ins. Co. of Pittsburg
19445-001
INSURERE: Ins. Co. of the state of PA
19429-000
Employers Liability (Stop Gap) coverage for Monopolistic States is included.
Certificate Holder is Additional Insured, except for Workers Compensation, if required by written
contract.
Coll:1821828 Tp1:571017 Cert:8195420
Page 3 of 3
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
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) Co11:1821828 Tn1:571017 care-aicsain