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Home My WebLink AboutRMCAT - INSURANCE CERTIFICATE (4)t c s F DD YYYY) 0 ., sa—D..,ATE(MM°- ,° '. 12/05/2005ACORDTM .. .et:. m'^.a.� ,u.re° +k .:: �., ,w,., x-°.aa +-.° ,,.:... -s -a—° e-m. • ,a_." %k,xa ,. PRODUCER ADD Risk Services, Inc. of Michigan THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY 3000 Town Center AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS Suite 3000 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE Southfield MI 48075 USA COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# PHONE 866) 283-7122 FAX-847 953-5390 INSURED INSURER A: Insurance Company of the State of PA 19429 RMCAT•EnvirOnmental Services, Inc. I= INSURERB: American Home Assurance Co. 19380 4975 Paris Street NSURERQ American International Specialty Lines 26883 Denver Co 80239 USA b INSURERD: Pinnacol Assurance Company 41190 ,- INSURER E: O U1154MULWAS W-1 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. R LT LTR A ESS TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE(MM\DMYY) DATE(MM)DD\YY) BGENERAL LIABILITY GL7047194 04/01/05 04/01/06 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $1,000,000 CLAIMS MADE ® OCCUR PREMISES (Ea oocurence) MED ( y one ceraon PERSONAL &ADV INJURY $1,000,000 m o GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: ,�-4 PRODUCTS - COMP/OP AGO $2,000,000 ❑ POLICY ® ❑ LOC JECT n B AUTOMOBILE LIABILITY AL9262001 04/01/05 04/01/06 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $1,000,000 Z ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS ( Per person) `J W HIAED AUTOS W X BODILY INJURY NON OWNED AUTOS (Per occident) :.J Comp Ded $1,000 X PROPERTY DAMAGE (Per accident' X Collision Ded $1.000 GARAGELIABILITY AUTO ONLY - EA ACCIDENT ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGG A EXCESS/UMBRELLA LIABILITY 43052604 04/01/0$ 04 1 EACH OCCURRENCErVI , OCCUR ❑ CLAIMS MADE AGGREGATE $10, 000, 000 DEDUCTIBLE RETENTION D WORKERSCOMPENSATIONAND X WC STAID- Y I OTH- R EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $500,000 0 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EMPLOYEE $500,000 _ OFFICER/MEMBER EXCLUDED') If yes, &.,critc under SPECIAL PROVISIONS DLSEASE-EA E.L. DISEASE -POLICY LIMIT $500, 000 below C CPL3779857 04/01/05 Per Claim Limit $15,000,000 i5 OTHER Contractors Poll Liab Deductible $100,000 Pollutn/Env Imp DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Re: Fort Collins ER Contract The City of Fort Collins is included as Additional Insured with respects to General Liability. waiver of Subrogation applies as required by contract. 2A City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Attn. James O'Neil II, CPPO,CPPB DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 215 North Mason, 2nd Floor 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, P.O. BOX 580 BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY W—•a OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Fort Collins Co 80522 USA ems'_' Fi. AUTHORIZED REPRESENTATIVE��/j4�� r$ w^O^D `=g # DATEMM DD �12/05/2005 • PRODUCER ADD Risk Services, Inc.of Michigan THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY 3000 Town Center AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS Suite 3000 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE Southfield MI 48075 USA COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# PHONE• 866 283-7122 FAx- 847 953-5390 INSURED INSURER A: Insurance Company of the State of PA 19429 RMCAT Environmental Services, Inc. INSURER : American Home Assurance Co. 19380 4975 Paris Street INSURER American International Specialty Lines 26883 Denver Co 80239 USA PC INSURER D: Pinnacol Assurance Company 41190 INSURER E: O OR . _. - ss ,- x- �" .&i4. a �' - #e ` MOU' 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 ADID1 INSRE TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE(MMIDDIYY) DATE(MMIDDIYY) B NERALLIABILITY GL7047194 04/01/05 04/01/06 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $1,000,000 CLAIMS MADE ® OCCUR PREMISES (Ea uccurence) (Any one perwn) 0 m PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GENE AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP)OP AGG $2,000,000 ❑ POLICY ® E O- ❑ LOC O O r` rn B AUTOMOBILE LIABILITY AL8262001 04/01/05 04/01/06 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $1,000,000 z ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) u X HIRED AUTOS BODILY INJURY NON OWNED AUTOS (Per xcident) X Comp Ded S1,000 PROPERTY DAMAGE (Per accident) X collision Ded 11.000 GARAGE LIABILITY AUTO ONLY - EA ACCIDENT ANY AUTO OTHER THAN EA ACC 8 AUTO ONLY AGG A EXCESS (UMBRELLA LIABILITY 43052604 04/01/05 04 1 EACH occuRRENCE , aOCCUR ❑ CLAIMS MADE AGGREGATE $10,000,000 eDEDUCTIBLE RETENTION O X WC STATU- OTH WORKERS COMPENSATION AND LIMITS ER EMPLOYERS' LIABILITYRY EMPLOY- o E.L EACH ACCIDENT $SOO, OOO ANY PROPRIETOR/PARTNER/EXECUTIVE i OFFICERIMEMBER EXCLUDED? E.L. DISEASE -EA EMPLOYEE $500,000 E.L. DISEASE -POLICY LIMIT $500, 000 If yes, descritw under SPECIAL PROVISIONS Aelow �� C CPL3779857 04/01/05 Per Claim Limit $15,000,000 OTHER Contractors Poll Liab Deductible $100, 000 �-_ Pollutn/Env Imp .jrL DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS y—i RE: FORTH COLLINS FIRING RANGE. 4 CITY OF FORT COLLINS SHOULD ATTN: DAMES Or NEIL II CPPO FNIGP ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 215 NORTH MASON STREET 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, P.O. BOX 590 BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY FORTH COLLINS CO 80522-0580 USA OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE • g