HomeMy WebLinkAboutCORRESPONDENCE - GENERAL CORRESPONDENCE - INSURANCE'
ACORD,M`ti''
< DATE(MMfDD/YY)
12/28/05
PRODUCER ADD Risk Services, Inc. Of New Mexico
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
6000 Uptown Blvd NE
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
Suite 400
Albuquerque NM 87110 USA
CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
PHONE (505) 889-6700 FAx 505 884-7831
INSURED
INSURERA. Midwest Employers Cas. Co.
ABC NM Chapter Merit Shop -WC Group
AUI inc.
INSURER B:
1NSURERC
P.U. BOX 9825
Albuquerque NM 87119-9825 USA
�.
INSURER D.
C
v
'p
rr
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.
'b
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE(MMV)DAYY)
POLICY EXPIRATION
DATE(MMIUDAYY)
LIMITS
rn
�
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE. OCCUR
EACH OCCURRENCE
O
O
0
�
,-1
00
n
FIRE DAMAGE(Anv one fires
MED EXP [Amy Dire nrnuN
PERSONAL & ADV INJURY
�^
GENERAL AGGREGATE
GEN'L AGGREGATE. LIMrf APPLIES PER:
PRODUCTS-COMP/OP AGG
PRO-
POLICY JECT LOC
O
z
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
7
L:
ANY AUTO
ALL OWNED AUTOS
(Ea uec'identl
'L
v
V
BODILY INJURY
SCHEDULED AUTOS
(Per 1' n'.'w
HIRED AUTOS
BODILY INJURY
NON OWNED AUTOS
/Per uccidow
PROPERTY DAMAGE
r Per uccidenq
GARAGE LIABILITY
AUTOONLY EA ACCIDENT
ANY AUTO
OTHER THAN EA ACC
AUTO ONLY
AGG
EXCESS LIABILITY
EACH OCCURRENCE
OCCUR ❑ CLAIMS MADE
AGGREGATE
DEDUCTIBLE
RETENTION
A
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY'
EWC005487
SIR Deductible $350,000
12/31/04
03/01/06
X
WC STATU-
TORY LIMITS
OTH-
ER
E.L. EACH ACCIDENT
$1,000,000
0
F,.L. DISEASE -POLICY LIMIT
$1,000,000
_
E.L. DISEASE EA EMPLOYEE
$1,000,000
CJ
OTHER
y
2i
DESCRIPTION OFOPERATIONS/LOCATIONSh'EHICLES/EXCLUSIONS ADDED BY ENDORSENIENT/SPECIAL PROVISIONS
RE: Pipe Bursting Project �y(y /y
L YJCi�c 3lTie i nhtAG i6
i s_ r
_
..
City of Fort Collins
Purchasing Division
215 N. Mason Street
Fort Collins CO 80522 USA BUT
a .
SHOULD ANY OFTHE 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,
FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
t €