HomeMy WebLinkAboutBIOKLEAN WORLD ENVIRONMENTAL - INSURANCE CERTIFICATE10/4/2007 8 58 AM FROM JOB Beckett _ASSOC.ates TO 2216707 PAGE 001 OF 002
ACORDM CERTIFICATE OF
LIABILITY INSURANCE
DATE
099/0/0 Y)
7/2002007
PRODUCER (970) 484-2805
Joha C Beckett S Associates, Inc
220 Smith Street
Ft Collins CO 80524-
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY 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#
INSURED
Bio K1ean World Environmental, Inc
145 West Swallow Road, Ste A2
Fort Collins CO 80525-2500
INSURERA BURLINGTON INSURANCE
CO
INSURERS
wsuRERc
wsuRER D
INSURER
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 CONTRACTOR 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
LTR
DDL
INSRDADDL
TYPE OF INSURANCE
POLICY NUMBER
DATE(MMICY FDOIYIYE
)
POLICY DATEMMMD/YY)N
LIMITS
A
GENERAL LIABILITY
21OB522032
07/27/2007
07/27/2008
EACH OCCURRENCE
$ 500,000
ED
PPEMISE5 Eaomweme
$ 100,000
X COMMERCIALGENERALIUVOJLITY
CLAIMS MADE OCCUR
/ /
/ /
MCDEXPIAnyone Person)
$ 5,000
PERSONALnADVIN,URY
$ 500,000
GENERAL AGGREGATE
$ 1,000,000
GEN L AGGREGATE LIMIT APPLIES
PER
PRODUCTS-COMP✓OP AGG
8 1,000,000
X POucv 'ROT
Loc
ALITOMOBILELIABILITY
MY AUTO
NO COVERAGE
/ /
/ /
COMBINED SINGLELIMIT
(E9 P W denI
$
BODILY INJURY
(Per person)
$
ALL OV ED AUTOS
Sr HEDULED AUTOS
/ /
/ /
BODILY INJURY
(Perecad I)
$
HIREDAUTOS
NON ONNEDAUTOS
/ /
/ /
PROPERTY DAMAGE
(Per er`gdenl
$
GARAGE LIABILITY
AUTO ONLY EAACCIDENT
$
OTHER THAN EAACC
$
ANY AUTO
NO COVERAGE
/ /
/ /
$
AUTO ONLY AGG
EXCESSIUMBRELLA LIABILITY
NO COVERAGE
/ /
/ /
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
b
DEDUCTIBLE
$
RETENTION $
VIORKERS COMPENSATION AND
EMPLOYERS LIABILITY
NO COVERAGE
/ /
/ /
T&YYTAATITS ER
LIM
EL EACH ACCIDENT
8
ANY PROPRIETOR/PARTNER/EXECUTIVE
ELDISEASE-EA FMPLOYEE$
OFFIOFR/MFMPFR FXCI LIEF"
/ /
/ /
Ityos do5amoundor
SPECIAL PROVI5109JSCnlrnv
ELDISEASE-POLYJYLRdIT
$
OTHER
NO COVERAGE
DESCRIPTION OF OPERATIONS,LOCATIONSNEHICLES,BXCLUSIONS ADDED BY ENDORSEMEWMPECML PROVISIONS
CERTIFICATE HOLDER IS LISTED AS ADDITIONAL INSURED IN REGARDS TO THE GENERAL LIABILITY
CERTIFICATE HOLDER CANCELLATION
( ) — (970) 221-6707 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
ADMINISTRATIVE SERVICES EXPIRATION DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL
10 DAYS N ITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT
CITY OF FORT COLLINS FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILffY OF ANY KIND UPON THE
e O BOX 580 I NSURER ITS A GENTS OR REP RESENTA TI VIES
AU CRIZED REPRESENTATIVE _
/
FORT COLLINS CO 80522-0580 --
%CORD 25 (2001108) OACORD CORPORATION 1988
k,- INS025 (1108) 05 ELECTRONIC LASEP FORMS INC-(800)321-0545 PM, I of 2
10/4/2007 8 58 AM FROM JCB Beckett _Associates TO 2216707 PAGE 002 OF 002
Tkff96T:Y1-'TLTH
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 Certhcate 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
M*,-I
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*, - I NS025 (0108) 05 Page 202