HomeMy WebLinkAbout125216 WALSH ENVIRONMENTAL - INSURANCE CERTIFICATE (7)3.no nu 19702238577 002
.A a(= CERTIFICATE OF LIABILITY INSURANCE
Keller -Lowry Insurance Inc
1777 S Harrison St #700
Denver, CO 80210
Margaret Rosa
DBA: & Engineers, LLC
4888 Pearl East Circle 8108
Boulder, CO 80301
INSURERS AFFORDING COVERAGE
NSURERA. PjMacol Assurance
r,
DATE ORMIDOfYYYYI
03/21/200S
IFORMATION
,TIFICATE
EXTEND OR
ICIES BELOW.
NAK: p
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REOUIREMENT, 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.
WEIR
TYPE OF INSURANCE
POLICYNUMBER
POLKV EFBEEFECTIVE
EXPIRATION
LBSTf
GEHERALLVUBILrTY
EACH OCCURRENCE
S
DAMAGE 0 R
$
COMMERCIAL GENERAL LIABILRY
NED EXP(Aeyone Pmeon)
$
CLAIMSMADE OCCUR
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
S
GENL AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPlOP AGO
S
POLICY JECT LOC
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
(Ea accident
S
ANY AUTO
BODILYNJJRY
(Per pmeon)
S
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILYINJURY
(Pm ecdderR}
$
HIRED AUTOS
NON -DINNED AUTOS
PROPERTYDAMAGE
(Per ecddem)
S
GARAGE UUBLITY
AUTO ONLY- EA ACCIDENT
$
OTHER THAN EAACC
AUTO ONLY AGO
S
ANY AUTO
$
EXCEffNMBRELLA LIABILITY
EACH OCCURRENCE
$
AGGREGATE
S
OCCUR CLAIMS MADE
S
$
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION AND
404SG61
O7/01/2004
07/Ol/ S
T Ry "T
E.L. EACH ACCIDENT
$ 1 000
EMPLOYERS' LIABILITY
A
OFF)CERRNtEMMBOEREKCTLUDED? TiVE
EL.DISEASE -EAEMPLOYEE
S 1,000
ELDISEASE-POLICILIIT
S 1 000
Ayes. describe under
SPECIAL PROVISIONS below
OTHER
OEfCRMfION OFOPERATIONSI OCATgNf IVEHICLHIEI(CLIMIONS ADM SNOORSEIAENTISPECIAL PRONlIga
e: Environmental Services Agreement: P-818
"Professional Liability Coverages Are Excluded from the above policies."
City of Fort Collins
Attn: James B. O'Neill
PO Box 580
Fort Collins, CO SOS22-0580
ernon�N tmINnMRT FAX:
SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURERWLL ENDEAVORTOMAL
—1(-OAYf wRfREN NOTICE TO THE CERTIFICATE HOLDER NAMEDTO THE LEFT,
BUT FAILURE TO MAL SUCH NOTICE SIYLLL HOSE NO OBLIGATION OR LASILRY
OF ANY Iwo UPON THE INSURER, ITS AGENTS OR REPREBENTATAIES.
AUTHORRED REPRESENTATIVE
Robert Sibelius, CIC/HAPPY —;ez
"CORD CORPORATION 1888
/ZU00 U:U3 PM
. i..-�wnnnnr nn AAQ
lY � var.+vvv �
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25 (200UOB)