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HomeMy WebLinkAbout125216 WALSH ENVIRONMENTAL - INSURANCE CERTIFICATE (6)ACORD. CERTIFICATE OF LIABILITY INSURANCE
0DATE 6/30/2003)
PRODUCER FAX (303) 756-8818
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
INSURERB: Plnnacol Assurance
INSURERC:
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.
INSIR
LSI
OF INSURANCE
POLICY NUMBER
POLICYIEFFECTTYPE
DATE (NiM
POLICY EXPIRATION
DATE EXPIRATION
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE a OCCUR
34UUNEM8078
01/10/2003
01/10/2004
EACH OCCURRENCE
$ 1,000,000
FIRE DAMAGE (Any one fire)
$ 300,00
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,00
GENERAL AGGREGATE
$ 2,000,000
GEHL AGGREGATE LIMIT APPLIES PER:
X POLICY PROJECT LOC
PRODUCTS - COMP/OP AGG
$ 2,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULEDAUTOS
HIRED AUTOS
NON-OWNEDAUTOS
34UUNEM8078
01/10/2003
01/10/2004
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
01/10/2003
01/10/2004
EACH OCCURRENCE
$ 4,000,000
AGGREGATE
$ 4,000,00
$
$
$
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
9066221
07/01/2003
07/01/2004
X TDRY LIMBS X OT
ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1 . 000 , 00
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS 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."
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
City Of Fort Collins' *30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Attn: James B . O'Neill, II BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
PO Box 580 OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
Fort Collins, CO 80522-OS80 AUTHORIZED REPRESENTATIVE
Robert Sibelius, CIC HAPPY
ACORD 25-S (7/97) FAY- C9701??7-67n7 ©ACORDCORPORATION 'IARA
ACORD. CERTIFICATE OF LIABILITY INSURANCE 0DATE (MMIDDNY)
6/30/2003
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
P LI Y E
DATE MMIDMIDDI
R
DATEY FXPIN
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE a OCCUR
X Blkt Addl Insd End
34UUNEM8078
01/10/2003
01/10/2004
EACH OCCURRENCE
$ 1,000,000
FIRE DAMAGE (Anyone fire)
$ 300,00
MED EXP (Any one person)
$ 5,000
PERSONAL &ADV INJURY
$ 1,000,00
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY X PRO LOC
JECT
PRODUCTS -COMP/OPAGG
$ 2,000,00
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON-OWNEDAUTOS
34UUNEM8078
01/10/2003
01/10/2004
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
X1 OCCUR ❑CLAIMS MADE
DEDUCTIBLE
RETENTION $
34XHUEU4384
01/10/2003
01/10/2004
EACH OCCURRENCE
$ 4,000,00
AGGREGATE
$ 4,000,00
$
$
$
BEXEC
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
4045661
OFFICERS & PARTNERS
INCLUDED
07/01/2003
07/01/2004
WC STATU
TORY LIMITS I X ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,00
E.L. DISEASE -POLICY LIMIT
$ 1.000,00
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS 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."
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
City of Fort Collins 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Attn • James B. O'Neill BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
PO BOX 580 OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
Fort Collins, CO 80522-0580 AUTHORIZED REPRESENTATIVE
FAY! (e7nI221-67n7