HomeMy WebLinkAboutAON RISK SERVICES - INSURANCE CERTIFICATEACORD x _' .,'
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E :3. i N _ ._ DATE(MM DD YY)
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ee000n Risk Services, Inc. of New Mexico
Aon
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
6000 Uptown Blvd NE
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
Suite 400
CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
Albuquerque NM 87110 USA
COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
PHONE SOS 889-6700 FAX- 505 884-7831
INSURED
INSURER A: Midwest Employers Cas. Co.
:New Mexico Chapter Merit Shop -WC Group
ALI Inc.
INSURERB:
INSURERC
P.O. BOX 9825
Albuquerque NM 87119-9825 USA
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ORIGINAL
INSURER D:
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INSURER EROVINAMP:
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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
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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 EFFECTIVEPOLICY
DATE(MIIIADDAYY)
EXPIRATION
DATE(MMADMYY)
LIMITS
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GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
EACH OCCURRENCE
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FIRE DAMAG&Anv mte fire)
MED EXP fAnv one Pers,N
PERSONAL X ADV INJURY
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GENERAL AGGREGATE
GEN'L AGGREGATE LIMIT APPLIES PER:
PRO-
POLICY1:1 JECT LOC
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PRODUCTS - COMP/OP AGG
Y
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
A
N
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ANY AUTO
ALL OWNED AUTOS
(Ea accident)
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BODILY INJURY
"SCHEDULED AUTOS
( Per Pervm)
BODILY INJURY
HIRED AUTOS
NON OWNED AUTOS
(Per accident)
PROPERTY DAMAGE
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
ANY AUTO
OTHER THAN EA ACC
AUTO ONLY:
AGG
EXCESS LIABILITY
EACH OCCURRENCE
OCCUR ❑ CLAIMS MADE
AGGREGATE
DEDUCTIBLE
RETENTION
A
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY
EW0005487
SIR Deductible $350,000
12/31/04
12/11/05
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WCRY STATU-
LIMITS
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OTH-
ILE
E.L. EACH ACCIDENT
$1,000,000
0
E.L. DISEASE -POLICY LIMIT
S1,000,000
_
E.L. DISEASE -EA EMPLOYEE $1.000,000
OTHER
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DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: Pipe Bursting Project
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City Of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
Purchasing Division DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
215 N. Mason street 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Fort Collins CO 80522 USA BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE C �
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