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HomeMy WebLinkAboutAPPLIED PAVEMENT TECHNOLOGY - INSURANCE CERTIFICATEACORU. CERTIFICATE OF LIABILITY INSURANCE DATE (MI 04/25/07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION WELLS FARGO INS SERVICES OF IL ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2107 S NEIL ST HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO BOX 4016 CHAMPAIGN, IL 61824-4016 INSURED APPLIED PAVEMENT TECHNOLOGY INC 115 W. MAIN STREET, SUITE 400 URBANA, IL 61801 INSURERS AFFORDING COVERAGE INSURERA: CNA INSURANCE COMPANIES INSURERS: UNITED FIRE_ & CASUALTY COMP INSURER C: INSURER D: INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR'(M�fpO INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT HI H 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDWYY POLICY EXPIRATION DATE MWDDNY LIMITS A _GE111NERALLIABILITY 2097713195 04/01/07 04/01/08 _EACHOCCURRENCE $1, 000L000 X COMMERCIAL GENERAL LIABILITY 1 CLAIMS MADE I- _ OCCUR FIRE DAMAGE (Any one lire) $3 0 Q 090 MED EXP (Any one person) $1 Q Q Q Q PERSONAL &ADV INJURY — $1_, 000,000 GENERAL AGGREGATE_ . $2 l, 000,000 ',qEN'L I AGGREGATE LIM ITAPPLIES PER: POLICY PRO JECT PRODUCTS -COMP/OP AGG $2 000 000 B AUTOMOBILE LIABILITY ANY AUTO 60359229 04/01/07 04/01/08 COMBINED SINGLE LIMIT (Ea accident) $1 , 000, 000 — -' f X jI ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per person) $ BODILY INJURY (Per accident)-- $ — — PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC _ AUTO ONLY: AGG $_ ANY AUTO • - I $ A EXCESS LIABILITY _ X] OCCUR �. _ _ j CLAIMS MADE 2097717957 04/01/07 04/01/08 EACH OCCURRENCE $4 _r__003_0000 ___ $4 , O O O , O O O _ _ AGGREGATE DEDUCTIBLE X RETENTION $10000 $ A I WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 2097212419 04/01/07 04/01/08 WCYLATIT OEH E.L. EACH ACCIDENT --- $1, 000,000 E.L. DISEASE -EAEMPLOYEE $1, 0001000 E.L. DISEASE -POLICY LIMIT $1 000, 000 OTHER DESCRIPTION OF OPERATIONWLOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS PERIOD OF PERFORMANCE 03/22/07 - 06/01/07 ADDITIONAL INSURED, HOLD HARMLESS PER CONTRACT: CITY OF FORT COLLINS, ITS OFFICERS AND EMPLOYEES IN ACCORDANCE WITH COLORADO LAW CITY OF FORT COLLINS ENGINEERING RICK RICHTER 281 N. COLLEGE AVE. FORT COLLINS, CO 80524 SHOULD ANYOF TH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TH E EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30__ DAYS WRITTEN NOTICETOTHE CERTIFICATE HOLDER NAMED TOTHE LEFT, BUTFAILURE TODD SO SHALL IM POSE NO OBLIGAAON OR LIABILITY OF ANY KIND UPON TH E INSURER,ITS AGENTS OR ACORD25-S(7/97)1 of 2 #S223163/M223149 AUTHORIZED JS S O ACORD CORPORATION 1988 ACORo. CERTIFICATE OF LIABILITY INSURANCE OP ID K DATE (MM/DD/YY7 APPLI-1 04 13 0 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Brown, Hobbs & McMurray HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 118 S . Race St., P.O. Box 488 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Urbana IL 61803-0488 Phone: 217-367-4011 Fax:217-384-4346 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: CNA INSURER B. Applied Pavement Technology NsuRERc: Mary Bach _- 115 W. Main Street, Suite 400 INSURER Urbana IL 61801 -- ---- ---_ _..- -__— INSURER E. L.inva:a�ha.7 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 DD' LTR NSRO --- -"" --7— TYPE OF INSURANCE - POLICY NUMBER P LICY EFFE TIVE DATE MMIDD/YY POLICY EXPIRATI N DATE MM/ODlYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GE GENERAL LIABILITY CLAIMS MADE n OCCUR DAMAGETURENTED- PREMISES (Ea occurence) ------- - $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OP AGG $ POLICY PRO- JECT LOG AUTOMOBILE LIABILITY ANYAUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS $ BODILY INJURY (Per person) - - - HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ $ PROPERTY DAMAGE (Per accident) -- ----- GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $- - - $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR -] CLAIMSMADE AGGREGATE $ $ i DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY I TORY LIMITS ER ----------- —------- E.L. EACH ACCIDENT ANY PROPRIETOR/PARTNER/EXECUTIVE $ OFFICER/MEMBER EXCLUDED? If yes, describe under E. L. DISEASE - EA EMPLOYEE $ ------_..... -- --- E.L. DISEASE - POLICY LIMIT SPECIAL PROVISIONS below $ OTHER A Prof Liability AEH113964282 04/01/07 04/01/08 Per Claim 2000000 Aggregate 2000000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS Professional liab/archt/engin, consulting CERTIFICATE HOLDER CANCFI I ATI0N Per Contract SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 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 REPRESENTATIVES. ACORD 25 (2001108) ©ACORD