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330448 JACO ENVIRONMENTAL - INSURANCE CERTIFICATE (2)
ACORD� CERTIFICATE OF LIABILITY INSURANCE Page 1 of 2 09/18/2007 PRODUCER 877-945-7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Willie 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 Nashv, Ile, IN 372305191 INSURERS AFFORDING COVERAGE NAIC# INSURED ,TACO Environmental, Inc. INSURERA Lexington Insurance Cc 19437-000 INSURERS St Paul Fire and marine Insurance Compan 24767-001 PO Box 1478 Snohomish, WA 98291 INSURERC Commerce and Industry Insurance Company 19410-003 INSURERD American International Specialty Lines In 26883-002 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 ILTH S RE TYPE OF INSURANCE POUCYNUMBER POLICY EFFECTIVE POLICY EXPIRATIMD1YYION LIMITS A GENERAL LIABILITY 7355318 9/15/2007 9/15/2008 EACH OCCURRENCE $ 2,000,000 PEIEMLSDAMAGE TO REN.TEDnce $ 1 O00 000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR MED E%P (Any one person) $ PERSONAL& ADV INJURY $ 1,000,000 X WA Stop Gap Included X $10,000 Deductible GENERALAGGREGATE S 2,000.000 GLAGGREGATE LIMIT APPLIESPER EN PRODUCTS COMP/OPAGG $ Z OOO OOO X POLICY PRO LOC JECT AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident)$ BODILY INJURY (Per person) $ ALLOWNEDAUTOS SCHEDULED AUTOS BODILY INJURY (Peracciden0 $ HIREDAUTOS NON OWNED AUTOS PROPERTY DAMAGE (Peracntlent) $ GARAGE LIABILITY AUTOONLV EAACCIDENT $ OTHERTHAN EAACC $ ANY AUTO $ AUTO ONLY AGG B EXCESSAIMBRELLA LIABILITY QK08400067 9/15/2007 9/15/2008 EACH OCCURRENCE $ $ 000 000 X OCCUR 1-1 CLAIMS MADE AGGREGATE $ 5 000 000 S $ DEDUCTIBLE $ X RETENTION $ 10.00( C WORKERS COMPENSATION AND EMPLOYERS LIABILITY ADS WC3424398 2/28/2007 2/28/2008 X I TVRVLIMTs 1 2 1 EL EACH ACCIDENT _ $ 1 000 000 C ANY PROPRIETOR/PARTNER/EXECUTIVE CJV WC3424399 2/28/2007 2/28/200$ EL DISEASE EA EMPLOYEE $ 1,000,000 OFFICER/MEMOEREXCLUDED'+ If yes describe under SPECIAL PROVISIONS below EL DISEASE POLICVLIMIT 1 $ 1 000.000 D OTHER 1361078 9/15/2007 9/15/2008 Pollution Legal Liability $1,000,000 Per Incident including BI/PD & Cleanup $2,000,000 Aggregate 25 000 Deductible Each Incident DESCRIPTION OF OPERATIONS/LOCATIONSN5HICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS The Workers' Compensation 'AOS' policy covers Oregon, Nevada, and Utah only. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL City of Fort Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR Purchasing Division Attn Christine Patterson -Jarvis REPRESENTATIVES AUTHORIZED R RESENTATIVE 700 Wood Street Fort Collins, CO 80522-0580 - ACORD 25(2001/08) Co11:2113054 Tpl:679651 Cert:9495F 46 © ACORD CORPORATION 1988 Page 2 of 2 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) Co11:2113054 7p1:679651 Cert:9485346