HomeMy WebLinkAboutWESTERN WATERPROOFING BRISK HARRY S PETERSON - INSURANCE CERTIFICATECERTIFICATE OF INSURANCE ISSUE DATE 2 13 2006
PRODUCER
Certificate Number: WESTERN101805
Marsh USA Inc.
701 Market Street, Suite 1100 COMPANIES AFFORDING COVERAGE
St. Louis MO 63101
A Travelers Property Casualty Company of Ameria
INSURED B Travelers Indemnity Co. of Connecticul
Western Waterproofing Co., Inc.
Brisk Waterproofing Co. C The Travelers Indemnity Company of Ameria
Harry S. Peterson Company
Western Restoration & Waterproofing Co.
Western Roofing and Insulation Co. D
1637 North Warson Road
E
St. Louis MO 6313280
4.-...�.
THIS IS TO CERTIFY THAT 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
CO
POLICY
EFFECT
POLICY EXPIRATION
LTR
TYPE OF INSURANCE
POUCY NUMBER
DATE(MMMDIW)
DATE(MMJDDNY)
LIMITS
GENERAL
LL401LITY
GENERAL AGGREGATE
y 4,000,0001
X
PRODUCTS -COMPIOPAGG.
y 4000000
A
c.MMERCLLLGENERALOABILRY
RTC2J-CO-I65D6564-T1L-05
10/01/05
10/01/06
FX OCOUR cwMa MapE
PERSONALBADV.INJURV
y 2000000
EACH OCCURRENCE
y 2 000 000
FIRE DAMAGE (My me Mel
y 300 000
X
Gen. Agg. One per project basis.
MED. EXPENSE (My we perwnl
y 5 000
AUTOMOBILE
LIABILITY
COMBINED SINGLE
A
X
ANY AUTO
RTC2J-CAP-165D6576-TIL-05
10/01/05
10/01/06
LIMIT
y 2000000
BODILY INJURY
B
ALL owNED AUTOS Texas
RTC2E-CAP-165D659A-TCT-05
10/01/05
10/01/06
SCHEDIAEDAUTOS
(Pg BySOA)
y
X
BODILYINJURY
HIRED AUTOS
X
NON -OWNED AUTOS
(Pp eccltlen[)
y
PROPERTY DAMAGE
y
EXCESS
LIABILITY
EACHOCCURRENCE
y
AGGREGATE
t
UMBRELLA FORM
OIHER TXAN UMBRELU FORM
WORKERS'COMPENSATION
x STATUTORY LIMITS
§gL ,e@°c�` { �'
and EMPLOYERS' LIABILITY
?,,_m,,; 3., u, •.
C
All states except AZ, MA, OR, W I
RTC2HUB-165D654-0-05
10/01/05
10/01/06
EACH ACCIDENT
s 1,000,000
and monopolistic
DISEASE -POLICY LIMIT
s 1000000
A
AZ, MA, OR and WI
RTRIUB-165D655-2-05
10/01/05
10/01/06
DISEASE -EACH EMPLOYEE
y 1,000,000
y
y
DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLESISPECIAL ITEMS BRANCH NO. 2/28
JOB: FORT COLLINS GARAGES/DECK COATING -FORT COLLINS, CO -WESTERN JOB NO. 06-703
The following are additional insured to the extent required by written contract with respect to work performed by or on
behalf of the named insured:
The City of Fort Collins, Colorado.
va
4 i
t t SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE INSURING COMPANY WILL MAIL
The City of Fort Collins, Colorado c a " c 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.
P.O. Box 580�
Fort Collins, CO 80522
E"
AUTHORIZED REPRESENTATIVE
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