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Home My WebLink AboutCORRESPONDENCE - GENERAL CORRESPONDENCE - 2004 INSURANCE CERTIFICATE1/29/2004 3:17 PM 19702216707 001 ACOR n. CERTIFICATE OF LIABILITY INSURANCE 1/10/200) Ol/10/2004 PRODUCER FAX (303) 756-8818 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Keller -Lowry Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 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 & INSURER A: Hartford Insurance Co Engineers, LLC INSURER Pinnacol Assurance Creekside Two, Suite 280 INSURER C. 2629 Redwing Road INSURER D. Fort Collins, CO. 80526 INSURERS 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 MAYBE 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 CMWDWM POLICY EXPIFWfIUW DATE MID LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE j OCCUR 34UUNEMS078 01/10/2004 01/10/2005 EACH OCCURRENCE $ 1 000 00 FIRE DAMAGE (Any one fire) $ 300,00( MED EXP (Any one person) $ S , OO PERSONAL & ADV INJURY $ 1,000,00( GENERAL AGGREGATE S 2,000,00( GEN'L AGGREGATE LIMIT APPLIES PER'. X POLICY JEa LOC PRODUCTS- COMP/OP AGG $ 2,000,00( A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NOILOWNED AUTOS 34UUNEM9078 01/10/2004 01/10/2005 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00C X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY- EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY. AGG $ $ A EXCESS LIABILITY X OCCUR 71 CLAIMS MADE DEDUCTIBLE RETENTION $ 34XHUEU4384 01/10/2004 01/10/2005 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 066221 07/01/2003 07/01/2004 X rORYLIMrrSX ER E L EACH ACCIDENT Is 1,000,000 EL. DISEASE -EA EMPLOYEE $ 1,000,00 EL.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 *10 Day Cancellation for Non -Payment of Premium Applies. "Professional Liability Coverages Are Excluded from the above policies." City of Fort Collins Attn: James B. O'Neill, II PO Box S80 Fort Collins, CO 8OS22-OS80 FAX: (970)221-6707 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL * 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Robert Sibelius. CIC/HAPPV 1/2s/2004 3:17 PM 19702216707 002 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.