HomeMy WebLinkAboutRMCAT ENVIRONMENTAL - INSURANCE CERTIFICATE (3)A CORDn � ��Iig
PRODUCER
Aon Risk Services, Inc. of Michigan
fta t DATE(MM/DD/YYYY)
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THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
3000 Town Center
Suite 3000
Southfield MI 48075 USA
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 #
Pxone- 866 283-7122 FAX- 847 953-5390
INSURED
INSURER A: American Home Assurance Co.
19380
"
RMCAT Environmental services, Inc.
4975 Paris Street
INSURERB: Insurance Company of the State of PA
19429
Denver CO'80239 USA
a
INSURER American International Specialty Lines
26883
INSURERD: Pinnacol Assurance Company
41190
p
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 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.
R
LTR
LT
A
INS
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIV
DATE(MM\DD\YY)
POLICY EXPIRATION
DATE(MM\DD\YY)
LIMITS
AQOERAL
LIABILITY
GL1774I44
04/01/06
04/01/07
EACH OCCURRENCE
$1,000,000
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
$1,000,000
CLAIMS MADE ® OCCUR
PREMISES (Ea occutence)
(Any one person
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO-
El LOC
PERSONAL &ADV INJURY
$1,000,000
oN0
r-1
N
N
O
n
GENERAL AGGREGATE
$2,000,000
PRODUCTS-COMP/OP AGG
$2,000,000
A
AUTOMOBILE LIABILITY
AL8262356
04/01/06
04/01/07
COMBINED SINGLE LIMIT
••
X ANY AUTO
(Ea accident)
$1,000,000
ALL OWNED AUTOS
SCHEDULEDAUTOS
d
BODILY INJURY
( Per person)
X HIRED AUTOS -
NON OWNED AUTOS
BODILYINJURY
(Per accident)
y
U
X Comp Ded $1,000
PROPERTY DAMAGE
(Per accident)
X
Collision Ded $1.000
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
ANY AUTO
8
OTHER THAN EA ACC
AUTO ONLY
AGG
B
EXCESS/UMBRELLA LIABILITY
43063821
04/01/06
4
EACH OCCURRENCE
$10,000,000
ElOCCUR ❑ CLAIMS MADE
AGGREGATE
$10,000,000
DEDUCTIBLE
RETENTION
D
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
4051232
INC7171937
04/01/06
04/01/07
X
WC STATU-
Y LIMIr
OTH-
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$500, 000
0
E.L. DISEASE -EA EMPLOYEE
E.L. DISEASE -POLICY LIMIT
$500,000
$500, 000
_
Cd
OFFICER/MEMBER EXCLUDED?
If yes, describe under SPECIAL PROVISIONS
below
C OTHER CPL3779857 04/01/06 Per Claim Limit $15,000,000
Pollutn/Env Imp Deductible $100,000
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Re: Fort Collins ER Contract
The City of Fort Collins is included as Additional Insured with respects to General Liability. waiver of
Subrogation applies as required by contract.
OWN
City Of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
Attn. lames O'Neil II, CPPO,CPPB DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
215 North Mason, 2nd Floor 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY
P.O. BOX nO OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
Fort Collins CO 80522 USA
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AUTHORIZED REPRESENTATIVE ��l
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