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HomeMy WebLinkAboutONYX SPECIAL SERVICES - INSURANCE CERTIFICATE- AMARW4�� f ) CERTIFICATE NUMBER _y HOU-000294552-01 - , PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS MARSH USA INC. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE WELLS FARGO PLAZA POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE [AFFORDED 1000 LOUISIANA BY THE POLICIES DESCRIBED HEREIN. SUITE 4000 COMPANIES AFFORDING COVERAGE HOUSTON, TX 77002 COMPANY 0056 -ONA-COPS-03/04 SCHC A COMMERCE & INDUSTRY INSURANCE CO. INSURED COMPANY ONYX SPECIAL SERVICES, INC. B AMERICAN HOME ASSURANCE CO 5098 PARIS STREET DENVER, CO 80239 COMPANY C AMERICAN INTERNATIONAL SPECIALTY LINES INS CO COMPANY D INS. CO. OF THE STATE OF PA (AIG) �a z � THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DDNY) POLICY EXPIRATION DATE (MM/DDIYY) LIMITS A GENERAL LIABILITY GL 4177311 07/01/03 07/01/04 GENERAL AGGREGATE $ 1,000,000 X PRODUCTS- COMP/OP AGG $ 1,000,000 COMMERCIAL GENERAL LIABILITY CLAIMS MADE Fx_] OCCUR PERSONAL & ADV INJURY $ 1,000,000 EACH OCCURRENCE $ 1,000,000 OWNER'S & CONTRACTOR'S PROT X FIRE DAMAGE (Any one fire) $ 1,000,000 MED EXP (Any one n $ 5,000 H AUTOMOBILE LIABILITY D004A00055 (TX) 07/01/03 07/01/04 COMBINED SINGLE LIMIT $ 1,000,000 X G ANY AUTO D004A00056 (MA) 07/01/03 07/01/04 BODILY INJURY $ G ALL OWNED AUTOS D004A00057(PR) 07/01/03 07/01/04 G SCHEDULED AUTOS D004A00058(ADS) 07/01/03 07/01/04 person) If HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per awident) $ PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: ANY AUTO EACH ACCIDENT $ AGGREGATE $ E EXCESS LIABILITY 702-0298 07/01/03 07/01/04 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 E X UMBRELLA FORM 650-0352 07/01/03 07/01/04 $ OTHER THAN UMBRELLA FORM D F WORKERS COMPENSATION AND EMPLOYERS'LIABILITY WC4552998 AOS ( ) WC4552999(AZ,ID,MD,VA) 07/01/03 07/01/03 07/01104 07/01/04 - X TORV LIMBS ER_ EL EACH ACCIDENT $ 1,000,000 B F THE PROPRIETOR/ X INCL PFFIC ERSARE: TIVE OFFICERS ARE: EXCL WC4553000(CA) WC4553001 nd,Oh,Wa,WI,WV,W ( Y) 07/01/03 07/01/03 07/01/04 07/01/04 EL DISEASE -POLICY LIMIT $ 1,000,000 EL DISEASE -EACH EMPLOYEE $ 1,000,000 C OTHER CONTRACTORS COPS 6192159 09/30/01 09/30/04 EACH CLAIM -I o'UUU'vvv OPS & PROF SVCS ENV INS TOTAL ALL CLAIMS 15,000,000 CLAIMS MADE FORM DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESISPECIAL ITEMS CITY OF FORT COLLINS IS INCLUDED AS ADDITIONAL INSURED(EXCEPT AS RESPECTS ALL COVERAGE AFFORDED BY THE WORKER'S COMPENSATION POLICY) AS REQUIRED BY WRITTEN CONTRACT, BUT ONLY FOR LIABILITY ARISING OUT OF THE OPERATIONS OF THE NAMED INSURED. . ._ wag SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL 'An DAYS WRITTEN NOTICE TO THE CITY OF FORT COLLINS 256 W. MOUNTAIN AVENUE CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR ATTN :JOHN STEPHEN LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE FORT COLLINS, CO 80522 ISSUER OF THIS CERTIFICATE. SA INC. By: Barry N. Smith By: Barry VALID AS OF: 66/27/03