HomeMy WebLinkAbout125216 WALSH ENVIRONMENTAL SCIENTISTS - INSURANCE CERTIFICATEClientlk 912
FCrli FNV
ACORUM CERTIFICATE OF LIABILITY
INSURANCE
DrfYYY)
01/17105
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
HRH of Upstate NY LLC
344 Delaware Ave
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Buffalo, NY 14202
716 856-1100
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
Walsh Environmental Scientists and
Engineers, LLC
4888 Pearl E Circle, Suite 108
Boulder, CO 80301
INSURERA: Commerce & Industry Ins. CO.
19410
INSURER B:
INSURER C:
INSURER D:
INSURER E:
COVERAGES
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
N DO
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MMI
01/10/05
POLICY EXPIRATION
DATE ININI
LIMBS
A
GENERAL LIABILITY
GL4178739
08/01/05
EACH OCCURRENCE
$3 000 000
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTPREMISE (Ea dooED
$500OOO
CLAIMS MADE � OCCUR
MED EXP (Any one person)
000
PERSONAL & ADV INJURY
00 000
GENERAL AGGREGATE
00 000
j
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
00 000
POLICY 7X PR T LOC
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY
(Per Person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
A
EXCESSIUMBRELLA LIABILITY
X OCCUR CLAIMS MADE
BE2681784
01/10/05
08/01105
EACH OCCURRENCE
$1 O OOO OOO
AGGREGATE
$10 000 000
$
$
DEDUCTIBLE
$
X RETENTION $ 10000
WORKERS COMPENSATION AND
WC STATU- OTH-
ORY LIMIT
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. DISEASE - EA EMPLOYEE
$
OFFICERIMEMBER EXCLUDED?
If yes describe under
SPECIAL PROVISIONS below
E.L. DISEASE- POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES! EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Certificate Holder is named as an additional insured as required by written contract or
agreement
EPIC FACILITY (T7)
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS, CO 80522-0580
LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _R n DAYS WRITTEN
:E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
iE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVE
rr Wmu co {.CDDUDa) 1 of 2 #M33451 SMD 0 ACORD CORPORATION 1988
Clientlte R12
ECnLFNV
ACORD- CERTIFICATE OF LIABILITY INSURANCE
DATE[MMID DIYYYY)
0111705
/05
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
HRH of Upstate NY LLC
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
344 Delaware Ave
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Buffalo, NY 14202
716 856-1100
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER A: Commerce A Industry Ins. Co.
19410
Walsh Environmental Scientists and
Engineers, LLC
INSURER B:
4888Pearl E Circle, Suite 108
INSURER C:
Boulder, CO 80301
INSURERD:
INSURER E:
COVERAGES
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.
LTR
R
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
(MMIDDIM
POLIDATE
TY EXPIRATION E IMMIDDIM
LIMITS
A
GENERAL LIABILITY
GL4178739
01/10/05
08/01/05
EACH OCCURRENCE
$3 000 000
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTPREMISES �OccEDnre ncaj
$5OO OOO
CLAIMS MADE O OCCUR
MED EXP (Any one person)
$50000
PERSONAL & ADV INJURY
s3,000.000
GENERAL AGGREGATE
$3 000 OOO
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
s3,000,000
POLICY FX PRO LOC
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY
(Per Person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
A
EXCESSIUMBRELLA LIABILITY
X1 OCCUR CLAIMS MADE
BE2681784
01/10/05
08/01/05
EACH OCCURRENCE
$1 O 000 000
AGGREGATE
$1 O 000 000
$
DEDUCTIBLE
$
X RETENTION $ 10000
WORKERS COMPENSATION AND
WC STATU- OTH-
LIMITPR
EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
OFFICERIMEMBER EXCLUDED?
If yes, describe under
E.L. DISEASE - POLICY LIMIT
$
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Certificate Holder is named as an additional insured as required by written contract or
agreement
BLDG 281 IACI STUDY (BN)
CITY OF FORT COLLINS
P O BOX 580
FORT COLLINS, CO 80522-0580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVE
AUUKU l5 (ZUUTIUB) 1 of 2 #M33451 SMD 0 ACORD CORPORATION 1988
Client#: 812
ECOLENV
ACORD- OF LIABILITY
INSURANCE
DATE (MMID
CERTIFICATE
01/17105DIYYYn
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
HRH of Upstate NY LLC
344 Delaware Ave
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Buffalo, NY 14202
716 856-1100
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
Walsh Environmental Scientists and
Engineers, LLC
4888 Pearl E Circle, Suite 108
Boulder, CO 80301
INSURER A: Commerce & Industry Ins. Co.
19410
INSURER B:
INSURER C:
INSURER D:
INSURER E:
COVERAGES
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.
LTR
N
TYPE OF INSURANCE
POLICY NUMBER
POLICYEFFECTIVE
DATE 1MM1DDfYY)
POLICY
DATE MMID YYI
LIMITS
A
GENERAL LIABILITY
GL4178739
01/10/05
08101/05
EACH OCCURRENCE
$3 000 000
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTEDPREMISES (Fa occurrenmi,
$500 000
CLAIMS MADE 51OCCUR
MED EXP (Any one person)
$50 000
PERSONAL B ADV INJURY
s3,000,000
GENERAL AGGREGATE
s3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
s3,000,000
POLICY X PRO LOC
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
A
EXCESSIUMBRELLA LIABILITY
BE2681784
01/10/05
08/01/05
EACH OCCURRENCE
$10 000 000
X OCCUR CLAIMS MADE
AGGREGATE
$10 000 000
$
DEDUCTIBLE
$
X RETENTION $ 10000
WORKERS COMPENSATION AND
TATUjI TH-
WC SLIMIT PR
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
OFFICERIMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE -POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Certificate Holder is named as an additional insured as required by written contract or
agreement
NIX FARM-PB ABATEMENT(CE)
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS, CO 80522-0580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _ n DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVE
AGUKU ZO (ZUUI/UIS) 1 of 2 #M33451 SMD 0 ACORD CORPORATION 1988
ACORD- CERTIFICATE OF
LIABILITY INSURANCE
0DATE
1/17105D
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
HRH of Upstate NY LLC
344 Delaware Ave
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Buffalo, NY 14202
716 856-1100
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
Walsh Environmental Scientists and
Engineers, LLC
4888 Pearl E Circle, Suite 108
Boulder, CO 80301
INSURER A: Commerce 8t Industry Ins. Co.
19410
INSURER B:
INSURER C:
INSURER D:
INSURER E:
PnvP9Ar-Fc
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.
LTR
N R
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION
LIMITS
A
GENERAL LIABILITY
GL4178739
01/10/05
08/01/05
EACH OCCURRENCE
$3000000
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTEDPREMISES (Ea �nrence)
$500OOO
CLAIMS MADE E_x_1 OCCUR
MED EXP (Any one person)
$50000
PERSONAL B ADV INJURY
$3 00O 000
GENERAL AGGREGATE
$3 000 000
G l AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
s3,000,000
POLICY X PRO- LOC
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
A
EXCESSIUMBRELLA LIABILITY
BE2681784
01/10/05
08/01/05
EACH OCCURRENCE
$10 000 000
X OCCUR CLAIMS MADE
AGGREGATE
$1000O 000
$
DEDUCTIBLE
$
X RETENTION $ 10000
WORKERS COMPENSATION AND
STATU- OTH-
TWCMITER
EMPLOYERS' LIABILITY
ANY PROPRIETORlPARTNERlEXECUTIVE
E.L. EACH ACCIDENT
Is
E.L. DISEASE - EA EMPLOYEE
$
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Certificate Holder is named as an additional insured as required by written contract or
agreement
FC BRWNFIELDS-HOLD(HS)
CITY OF FORT COLLINS
P.O. BOX 580
FORT COLLINS, CO 80522-0580
LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 'A0_ DAYS wRRTEN
:E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR
REPRESENTATIVE
ACORD 25 (2001/08) 1 of 2 #M33451 SMD o ACORD CORPORATION 1988
ClianH!• A19
FCOLFNV
ACORD- CERTIFICATE OF LIABILITY INSURANCE
DATE
01/17/05D )
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
HRH of Upstate NY LLC
344 Delaware Ave
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Buffalo, NY 14202
716 856-1100
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
Walsh Environmental Scientists and
Engineers, LLC
4888 Pearl E Circle, Suite 108
Boulder, CO 80301
INSURER A: Commerce & Industry Ins. CO.
19410
INSURER B:
INSURER C:
INSURER D:
INSURER E:
COVERAGES
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.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
(MMIDDIYY)
POLIDATE
TY EXPIRATION E fMMIDDIYYI
LIMITS
A
GENERAL LIABILITY
GL4178739
01/10/05
08/01/05
EACH OCCURRENCE
$3000000
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED PREMISES (Ea occurnencel
$500OOO
CLAIMS MADE � OCCUR
MED EXP (Any one person)
$50 000
PERSONAL &ADV INJURY
$3 00Q 000
GENERAL AGGREGATE
$3 O00 OOO
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
s3,000,000
POLICY X PROT LOC
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY
(Per person)
E
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHERTHAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
A
EXCESS/UMBRELLA LIABILITY
BE2681784
01/10/05
08/01/05
EACH OCCURRENCE
$1 O 000,000
X OCCUR CLAIMS MADE
AGGREGATE
$1 O 00O 000
E
$
DEDUCTIBLE
$
X RETENTION $ 10000
WORKERS COMPENSATION AND
TH-
WC ORY LIMITTATU PR
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EAQ.H ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
OFFICERIMEMBER EXCLUDED?
Ayes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE- POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Certificate Holder is named as an additional insured as required by written contract or
agreement
NIX FARM-PB RENOVATIO(CE)
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS, CO 80522-0580
LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30._ DAYS WRITTEN
:E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVE
ACORD 25 (2001108) 1 of 2 #M33451 SMD 0 ACORD CORPORATION 1988
r'linnfif• R49
FCOI FNV
ACORD. CERTIFICATE OF LIABILITY INSURANCE
DATE (MMID
01/17/05DNYYY)
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
HRH of Upstate NY LLC
344 Delaware Ave
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Buffalo, NY 14202
716 856-1100
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
Walsh Environmental Scientists and
Engineers, LLC
4888 Pearl E Circle, Suite 108
Boulder, CO 80301
INSURER A: Commerce 8t Industry Ins. Co.
19410
INSURER B:
INSURER C:
INSURER D:
INSURER E:
COVERAGES
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.
LTR
INSRDATE
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
(MMIDDfrn
POLICY EXPIRATION
DATE fMMIDDfYY)
LIMBS
A
GENERAL LIABILITY
GL4178739
01/10/05
08/01/05
EACH OCCURRENCE
$3000000
DPREMISES (Fa omrnance) AMAGE TO RENTED
$500OOO
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE a OCCUR
MED EXP (Any one person)
$50 000
PERSONAL &ADV INJURY
$3 OOO OOO
GENERAL AGGREGATE
s3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
s3,000,000
POLICY X PRO LOC
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
$
ANY AUTO
(Ea accident)
BODILY INJURY
$
ALL OWNED AUTOS
SCHEDULED AUTOS
(Per person)
BODILY INJURY
$
HIRED AUTOS
NON -OWNED AUTOS
(Per accident)
PROPERTY DAMAGE
$
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHERTHAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
A
EXCESSIUMBRELLA LIABILITY
BE2681784
01/10/05
08/01/05
EACH OCCURRENCE
$10000000
X1 OCCUR CLAIMS MADE
AGGREGATE
$10000 000
$
DEDUCTIBLE
$
X RETENTION $ 10000
WORKERS COMPENSATION AND
TATUj
TWOCSRYLIMIT OTH-
EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
OFFICERIMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE -POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Certificate Holder is named as an additional insured as required by written contract or
agreement
FIRING RANGE -LEAD SAM(T7)
CITY OF FORT COLLINS
300 LAPORTE AVE, PO BOX 580
FORT COLLINS, CO 80522-0580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL A III _ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVE
ACORD 25 (2001/08) 1 of 2 #M33451 SMD o ACORD CORPORATION 1988
ACORD,. CERTIFICATE OF LIABILITY INSURANCE 0DATE
1/17/05D
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
HRH of Upstate NY LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
344 Delaware Ave HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Buffalo, NY 14202
716 856-1100 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: Commerce 8r Industry Ins. Co. 19410
Walsh Environmental Scientists and INSURER B:
Engineers, LLC
INSURER C:
4888 Pearl E Circle, Suite 108 INSURER D:
Boulder, CO 80301
INSURER E:
i.wve w n_�c�
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.
LTR
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MM/DDIM
POLICY EXPIRATION
DATE IMMtDDIYY)
LIMITS
A
GENERAL LIABILITY
GL4178739
01/10/05
08/01/05
EACH OCCURRENCE
$3 000 000
DPREMISES (Ea occurneriml AMAGE TO RENTED
$500 000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE Fx1 OCCUR
MED EXP (Any one person)
$50 000
PERSONAL B ADV INJURY
s3,000,000
GENERAL AGGREGATE
s3.000.000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
$3 00O 000
POLICY X PRO LOC
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULEDAUTOS
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY -EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
A
EXCESSIUMBRELLA LIABILITY
BE2681784
01/10/05
08/01/05
EACH OCCURRENCE
$10 000 000
X1 OCCUR CLAIMS MADE
AGGREGATE
$1000O 000
$
DEDUCTIBLE
Fx
$
RETENTION $10000
WORKERS COMPENSATION AND
TATU- -
WC SOTH
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
I $
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Certificate Holder is named as an additional insured as required by written contract or
agreement
POUDRE RIVER RESTORAT(GG)
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS, CO 80522-0580
LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _.30,_ DAYS WRITTEN
:E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
iE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVE
ACORD 25 (2001/08) 1 of 2 #M33451 SMD 0 ACORD CORPORATION 1988
ACORD- CERTIFICATE OF
LIABILITY INSURANCE
(MMID
0DATE
1/17/05DNYYY)
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
HRH of Upstate NY LLC
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
344 Delaware Ave
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Buffalo, NY 14202
716 856-1100
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER A: Commerce & Industry Ins. Co.
19410
Walsh Environmental Scientists and
INSURER B:
Engineers, LLC
INSURER C:
4888 Pearl E Circle, Suite 108
INSURER D:
Boulder, CO 80301
INSURER E:
t rAWPDAGPS
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.
NS
LTR
N R
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
iMMIDDIYYi
LIICY EXPIRATION
POLDATE TE IMMIDD[M
LIMITS
A
GENERAL LIABILITY
GL4178739
01/10/05
08/01/05
EACH OCCURRENCE
$3 000 000
DPREMISES (Fa occurrence) AMAGE TO RENTED
ESOO OOO
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE Ex_] OCCUR
MED EXP (Any one Person)
$50000
PERSONAL B ADV INJURY
$3 000 000
GENERAL AGGREGATE
s3 OOO OOO
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$3 00O 000
POLICY X PRO LOC
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
A
EXCFSSIUM13RELLA LIABILITY
BE2681784
01/10/05
08/01/05
EACH OCCURRENCE
$10 000 000
X OCCUR CLAIMS MADE
AGGREGATE
$1 O 00O 000
$
RDEDUCTIBLE
$
X RETENTION 00000
WORKERS COMPENSATION AND
WCSLT MITTUj
OFR
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
-
E.L. EACH ACCIDENT
-_
$
E.L. DISEASE - EA EMPLOYEE
$
OFFICERIMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
1 It
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Certificate Holder is named as an additional insured as required by written contract or
agreement
POUDRE RIVER CLEANUP (HS)
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS, CO 80522-0580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3111 WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR
REPRESENTATIVE
ACORD 25 (2001/08) 1 Of 2 #M33451 SMD 0 ACORD CORPORATION 1988