HomeMy WebLinkAbout125216 WALSH ENVIRONMENTAL - INSURANCE CERTIFICATE (5)ACORD. CERTIFICATE OF LIABILITY INSURANCE
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PRODUCER FAX (303) 7S6-8818
Keller -Lowry Insurance Inc
1777 S Harrison St #700
Denver, CO 80210
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
INSURED Walsh Environmental Scientists &
Engineers, LLC
Creekside Two, Suite 280
2629 Redwing Road
Fort Collins, CO. 80526
INSURER A: Hartford Insurance Co
INSURERS: Plnnacol Assurance
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
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDDIYY
POLICY EXPIRATION
DATE MMIDDIYY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FX] OCCUR
34UUNEM8078
01/10/2004
01/10/2005
EACH OCCURRENCE
$ 1,000,000
FIRE DAMAGE (Any one fire)
$ 300,000
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY PRO CT LOC
JE
PRODUCTS - COMP/OP AGG
$ 2,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
34UUNEM8078
01/10/2004
01/10/2005
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
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 ❑ CLAIMS MADE
DEDUCTIBLE
RETENTION $
34XHUEU4384
01/10/2004
01/10/200S
EACH OCCURRENCE
$ 4,000,000
AGGREGATE
$ 4,000,000
$
$
$
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
9066221
07/01/2003
07/01/2004
X I TOCY LIMITS X ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLESIEXCLUSIONS 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 580
Fort Collins, CO 80522-0580
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
FAX- r47n1??1_A7n7
ACORD� CERTIFICATE OF LIABILITY INSURANCE o1/10/2004
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 INSURERS: Pinnacol Assurance
4888 Pearl East Circle, #108 INSURER C:
Boulder, Colorado 80301 INSURER D:
INSURER E:
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
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDDIYY
POLICY EXPIRATION
DATE MMIDDIYY
LIMITS
GENERAL LIABILITY
34UUNEM8078
01/10/2004
01/10/2005
EACH OCCURRENCE
$ 1, 000, 00
A
X COMMERCIAL GENERAL LIABILITY
CLAIME LIADE F`Xj OCCUR
X Bl kt Addl Insd End
-
FIRE DAMAGE (Anyone fire)
$ 300,000
MED EXP (Any one perso, i)
$ 5,00(
PERSONAL & ADV INJURY
$ 1,000,00(
GENERAL AGGREGATE
$ 2,000,00(
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY X PRO LOC
JECT
PRODUCTS - COMP/OP AGG
$ 2,000,00(
AUTOMOBILE
LIABILITY
ANY AUTO
34UUNEM8078
01/10/2004
01/10/2005
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
'000,00
X
BODILY INJURY
(Per person)
$
A
ALL OWNED AUTOS
SCHEDULEDAUTOS
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
OTHER THAN EAACC
AUTO ONLY: AGG
$
$
EXCESS LIABILITY
X OCCUR CLAIMS MADE
34XHUEU4384
01/10/2004
01/10/2005
EACH OCCURRENCE
$ 4,000,000
AGGREGATE
$ 4,000,000
A
$
DEDUCTIBLE
RETENTION $
$
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
4045661
07/01/2003
07/01/2004
TORY LIMITS X ER
E.L. EACH ACCIDENT
$ 1,000,0010
B
EXEC OFFICERS & PARTNERS
E.L. DISEASE - EA EMPLOYE
$ 11000,000
INCLUDED
E.L. DISEASE -POLICY LIMIT
$ 11000,00
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
e: Environmental Services Agreement
City of Fort Collins is added as Additional Insured for General Liability as respects their
interest by contract with the named insured.
"Professional Liability Coverages Are Excluded from the above policies."
City of Fort Collins
Attn: James B. O'Neill
PO Box 580
Fort Collins, CO 80522-0580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
10 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. CTC/HAPPY
FAX: C970)221-6707