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HomeMy WebLinkAbout125216 WALSH ENVIRONMENTAL - INSURANCE CERTIFICATE (10)Client#: 812
ECOLENV
ACORDTM CERTIFICATE OF LIABILITY INSURANCE
osozroSD"YYY)
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
HRH of Upstate New York, LLC
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
r
344 Delaware Avenue
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 & Industry Ins. Co.
19410
Walsh Environmental Scientists and
Engineers, LLC.
NSURER B:
4888 Pearl E Circle, .Suite 108
INSURER C:
Boulder, CO 80301
INSURER D:
INSURER E:
UUVE
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
NSRd
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
(MMIDDIYYI
POLICY EXPIRATIONDATE
DATE fMM1DD/YY1
LIMBS
A
GENERAL LIABILITY
GL4178739
08/01/05
08/01/06
EACH OCCURRENCE
$3 000 000
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
PREMISES jaMED
$5OO OOO
EXP (Any one person)
$50000
CLAIMS MADE a OCCUR
PERSONAL &ADV INJURY
s3.000.000
GENERAL AGGREGATE
s3 00D 000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$3 00O 000
POLICY PRO LOC
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
CA5053647
08/01/05
08/01/06
COMBINED SINGLE LIMIT
(Ea accident)
$2,DOO,UDO
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
E
ANY AUTO
$
AUTO ONLY: AGG
A
EXCESSIUMBRELLA LIABILITY
X OCCUR CLAIMS MADE
BE2681858
08/01/05
08/01/06
EACH OCCURRENCE
$10 000 000
AGGREGATE
$10 00D 000
E
RDEDUCTIBLE
X RETENTION $10000
$
WORKERS COMPENSATION AND
WC STATU- OTH-
TORY LIMITS I PR
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$
ANY PROPRIETOR/PARTNERIEXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes de — be under
SPECIAL PROVISIONS below
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
MOLD ASSESSMT 200 MTN(TR)
CITY OF FORT COLLINS
835 WOOD ST
FORT COLLINS, CO 80526
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL An 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
^- ••- -� r-�� „vvI I OT c iFMJ4!JVZ SMD 0 ACORD CORPORATION 1988
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 25S (2001108) 2 of 2 #M34992
ClinnHt• Rig
�n�r r•uv
ACORD.M CERTIFICATE OF LIABILITY INSURANCE
DATE(
5D""YY)
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
I RH of Upstate New York, LLC
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
344 Delaware Avenue
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
INSURERA: Commerce 8: Industry Ins. Co.
19410
Walsh Environmental Scientists and
INSURERS:
Engineers, LLC.
4888 Pearl E Circle, Suite 108
INSURER C:
Boulder, CO 80301
INSURER D:
INSURER E:
CO
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
INSRd
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
(MWDDIYYI
POLICY EXPIRATIONDATE
DATE (MMIDDnM
LIMBS
A
GENERAL LIABILITY
GL4178739
08/01/05
08/01/06
EACH OCCURRENCE
$ 3 000 000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE O OCCUR
DAMAGE TO RENTED
$500 000
MED EXP (Any one person)
$50000
PERSONAL &ADV INJURY
s3.000.000
GENERAL AGGREGATE
s3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS -COMPIOP AGG
$3000000
POLICY PRO LOC
A
AUTOMOBILE LIABILITY
X ANY AUTO
CA5053647
08/01/05
08/01/06
COMBINED SINGLE LIMIT
(Ea aoddent)
$2,000,000
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per person)
$
X HIREDAUTOS
X NON -OWNED AUTOS
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Peraccident)
$
GARAGE LIABILfTY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
A
EXCESSIUMBRELLA LIABILITY
X OCCUR ❑ CLAIMS MADE
BE2681858
08/01/05
08/01/06
EACH OCCURRENCE
$10 000.000
AGGREGATE
$10 000 000
$
RDEDUCTIBLE
X RETENTION $ 10000
$
WORKERS COMPENSATION AND
WC STATU- OTH-
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICERIMEMBER EXCLUDED?
If yes, describe under
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE -POLICY LIMIT
E
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROWSIONS
PARK SHOP MOLD ASSESS(TL)
CITY OF FORT COLLINS
835 WOOD ST
FORT COLLINS, CO 80526
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ,RD_ 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
--^- -� t--- ••��/ I Of c WIVII SMD 0 ACORD CORPORATION 1988
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 25S (2001108) 2 of 2 #M34992