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ACORDTM CERTIFICATE OF LIABILITY INSURANCE
DATE(MMID DIYYYY)
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107
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
HRH of Upstate New York, LLC
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
344 Delaware Avenue
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Buffalo, NY 14202
716 856-1100
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER A: Commerce & Industry Ins. Co.
19410
Walsh Environmental Scientists &
Engineers, LLC
INSURER B:
4888 Pearl E. Circle, .Suite 108
INSURER C:
Boulder, CO 80301
INSURER D:
INSURER E:
COVERAGES
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.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMID
POLICY EXPIRATION
AT M DDIYY
LIMITS
A
GENERAL LIABILITY
GL4178739
08/01/06
08/01/07
EACH OCCURRENCE
$3000000
COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTPREMISES (E..c.ED
$SOO QQQ
MED EXP (Any one person)
$50000
CLAIMS MADE a OCCUR
PERSONAL &ADV INJURY
s3,000,000
GENERAL AGGREGATE
$3 00O 000
GI AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$3000000
17 POLICY PRO LOC
JECT
A
AUTOMOBILE
LIABILITY
ANY AUTO
CA5053647
08/01/06
08/01/07
COMBINED SINGLE LIMIT
(Ea accident)
$2,000,000
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
A
EXCESSIUMBRELLA LIABILITY
X OCCUR CLAIMS MADE
BE5190387
08/01/06
08/01/07
EACH OCCURRENCE
$10 000 000
AGGREGATE
$1000O 000
$
FDEDUCTIBLE
$
X RETENTION $ 10000
WORKERS COMPENSATION AND
WC STATU- OTH-
CRYI ER
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. DISEASE- EA EMPLOYEE
$
OFFICER/MEMBER EXCLUDED?
If yes, describe under
E.L. DISEASE - POLICY LIMIT
$
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
RE: P1069 Geo-Spatial Imagery & Vegetation Classification --- The City of
Fort Collins is named as an additional insured on the general liability as
required by written contract.
City of Fort Collins
215 North Mason Street, 2 nd
Floor
Fort Collins, CO 80522-0580
LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10_ DAYS WRITTEN
:E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVE
A+ VKU cD jcvV11V0] t of 2 #M37024 SMD 0 ACORD CORPORATION 1988
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.
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