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Home My WebLink AboutCORRESPONDENCE - GENERAL CORRESPONDENCE - INSURANCE CERTIFICATE 2004 (2)ACORD,� CERTIFICATE OF LIABILITY INSURANCE DATE PRODUCER FAX (303) 756-8818 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Keller -Lover Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Y HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1777 S Harrison St #700 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Denver, CO 80210 INSURERS AFFORDING COVERAGE INSURED Walsh Environmental Scientists & INSURERA: Hartford Insurance Co Engineers, LLC INSURER B: Pinnacol Assurance Creekside Two, Suite 280 INSURER C: 2629 Redwing Road INSURER D: Fort Collins, CO. 80526 INSURER E: v 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 RESPECTTO 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. ILTR TYPE OF INSURANCE POLINSRCY NUMBER POLICY —EFFECTIVE DATE MMIDDIYY POLICY EXPIRATION DATE MMIDDIYY LIMITS GENERAL LIABILITY 34UUNEM8078 01/10/2004 01/10/2005 EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire) $ 300,000 X COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $ 5,000 CLAIMS MADE � OCCUR PERSONAL & ADV INJURY $ 1,000,000 A GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PRO-LOC JECT AUTOMOBILE LIABILITY ANY AUTO 34UUNEM8078 01/10/2004 01/10/2005 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ A ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ ANY AUTO 1 $ EXCESS LIABILITY 34XHUEU4394 01/10/2004 01/10/2005 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 X OCCUR CLAIMS MADE $ A $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND 9066221 07/01/2003 07/61/2004 X TORY LIMITS I X I ER E.L. EACH ACCIDENT $ 1,000,000 EMPLOYERS' LIABILITY B E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS e: P-818 Environmental Services for the City of Fort Collins r10 Day Cancellation for Non -Payment of Premium Applies. 'Professional Liability Coverages Are Excluded from the above policies." SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE - EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL City of Fort Collins' * 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Attn: James B. O'Neill, II BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY PO Box S80 OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE / nx/ Fort Collins, CO 80522-0580 Robert Sibelius, CIC/HAPPY XA Ac,Urcu La -a marl FAX: (97U)221-67U/ ACOR ,,M CERTIFICATE OF LIABILITY INSURANCE 01/10/2004 PRODUCER FAX (303) 756-8818 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Keller -Lover Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Y HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1777 S Harrison St #700 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Denver, CO 80210 INSURERS AFFORDING COVERAGE Walsh Environmental Scientists Engineers, LLC 4888 Pearl East Circle, #108 Boulder, Colorado 80301 INSURER A: Hartford Insurance Co INSURERB: Pinnacol Assurance INSURER C: INSURER D: 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. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDDIYY POLICY EXPIRATION DATE MMIDDM/ LIMITS GENERAL LIABILITY 34UUNEM8078 01/10/2004 01/10/2005 EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire) $ 300,000 X COMMERCIAL GENERAL LIABILITY tdED EXP (Any one pereon) $ 5,000 CLAIMS MACE I OCCUR - PERSONAL & ADV INJURY $ 1,000,000 A X Bl kt Addl Insd End GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY X PRO LOC JECT AUTOMOBILE LIABILITY ANY AUTO 34UUNEM8078 01/10/2004 01/10/200S COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ A ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHERTHAN EA ACC AUTO ONLY: AGG $ ANY AUTO $ EXCESS LIABILITY 34XHUEU4384 01/10/2004 01/10/2005 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 X OCCUR CLAIMS MADE $ A $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND 04S661 07/01/2003 07/01/20004 TORY LIMITS X ER E.L. EACH ACCIDENT $ 1,000,00 B EMPLOYERS' LIABILITY EXEC OFFICERS & PARTNERS E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,000 INCLUDED OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS e: Environmental Services Agreement ity of Fort Collins is added as Additional Insured for General Liability as respects their interest by contract with the named insured. "Professional Liability Coverages Are Excluded from the above policies." ^=MD 11E1+AT= 1U1^1 nvo 1 V 1 A CAML-FI I ATIfIM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL City of Fort Collins 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Attn • James B . O'Neill BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY PO Box 580 OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE �) / Fort Collins, CO 80522-0580 Robert Sibelius, CIC/HAPPY AL.UKU LO-a If IV II FAX: (970)ZZ1-b7U7