HomeMy WebLinkAboutRMCAT - INSURANCE CERTIFICATE (6)ACORD,M CERT4F1CA� Qo Ty SURAINVF -
a DATE(MM/DD/ri)
�. 12 12 03
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Aon Risk Services, Inc. of Michigan
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
3000 Town Center
Suite3000
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Southfield
Southfield MI 48075
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
COMPANY American Home Assurance Co.
PHONE- (847) 953-5726 FAX- (847) 953-5390
A
INSURED
COMPANY American International Specialty Lines
RMCAT Environmental Services, Inc.
B
4975 Paris Street
Denver CO 80239 USA
COMPANY Insurance Company of the State of PA
COMPANY Pinnacol Assurance Company
D
COVERAGES
THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
T1pE OF INSCRANCE
POLICI' NUMBERPOLICY
EFFECTIAT
DATE Il1A1/DD/lll
POLICY EXPIRATION
DATE INIII/DD/YY1
LIMITS
A
GENERAL LIABILITY
GL9332523
04/01/03
04/01/04
GENERAL AGGREGATE
S2,000,000
X COMMERCIAL GENERAL LIABILITY
General Liability
PRODUCTS - COMPr'OP AGG
S2,000,000
CLAIMS MADE OCCUR
PERSONAL BADVINJURY
$1,000,000
OWNER'S 8 CONTRACTOR'S PROT
EACH OCCURRENCE
$1, 000, 000
FIRE DAMAGE(Any one fire)
S100,000
MED EXP (Any one person)
S5,000
A
AUTOMOBILE LIABILITY
CA8261349
04/01/03
04/01/04
COMBINED SINGLE LIMIT
S2,000,000
X ANY AUTO
Auto Liability
BODILY INJURY
ALL OWNED AUTOS
SCHEDULED AUTOS
I Per person)
BODILY INJURY
X HIRED AUTOS
X NON -OWNED AUTOS
(Per accidern)
PROPERTY DAMAGE
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
ANY AUTO
OTHER THAN AUTO ONLY
EACH ACCIDENT
AGGREGAT
C
EXCESS LIABILITY
4303-3894
04/01/03
04/01/04
EACH OCCURRENCE
S5,000,000
X UMBRELLA FORM
Umbrella Policy
AGGREGATE
b5,000,000
OTHER THAN UMBRELLA FORM
D
WORKER'S COMPENSATION AND
4051232
12/14/03
12/14/04
WC STATU-
V IMIT
DTH-
EMPLOYERS'LIABILITY
CO -Workers Compensation
EL EACH ACCIDENT
$500,000
THE PROPRIETOR/ INCL
PARTNERSEXECUTIVEEl
EL DISEASE -POLICY LIMIT
S500,000
OFFICERS ARE: EXCL
EL DISEASE -EA EMPLOYEE
5500,000
B
CPL3779857
04/01/03
04/01/04
Per Occurrence Limit 515,000,000
Contractors Pollution Liabili
X P011utn/Env Imp
Aggregate Limit $15,000,000
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/SPECIAL ITEMS
RE: FORTH COLLINS FIRING RANGE.
CERTIFICATE HOLDER ,, .� .<; CANCELLATION •., ;;;:
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CITY OF FORT COLLINS
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVORTO MAIL
ATTN: JAMES O'NEIL II CPPO FNIGP
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
215 NORTH MASON STREET
P.O
P.O. BOX 580
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
FORTH COLLINS CO 80522-0580 USA
OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES
AUTHORIZED REPRESENTATIVE
ACORD 25 S 1195
CORD CORPORATION INS
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